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Borrelia burgdorferi and Cutaneous MALT Lymphoma: Skin normally does not have an associated B-cell lymphocyte population. Chronic antigenic stimulation can lead to the development of skin associated lymphoid tissue and eventually to the emergence of a B-cell clone.

An association has been reported between a proportion of primary cutaneous MALT lymphomas (left panel) and infection by the spirochete Borrelia burgdorferi - a tick-borne obligate parasite causing Lyme disease (right panel; immunofluorescence stain). Some cutaneous MALT lymphomas have regressed following antibiotic therapy. However, there are significant geographic differences. Association has been noted in cases from Scotland, France, and Austria but not in the United States, Italy, and Asian countries. Rare cases of cutaneous MALT lymphomas have occurred following tattoos and vaccinations.

Image credit: Borrelia burgdorferi - National Institute of Allergy and Infectious Diseases; public domain.

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