Prevalence and etiology of erythema migrans among children in northeast Ohio

Objective: To determine the prevalence of erythema migrans (EM) in northeast Ohio; to identify demographic, health, and dental characteristics associated with this condition in patients aged 1 to 15 years; and to investigate the possibility that EM is a marker for children with multiple medications and certain systemic conditions. Method and Materials: In this retrospective chart review study, 1,900 charts were reviewed at 2 separate offices. One thousand were analyzed at a hospital dental clinic in Cleveland, Ohio, and 900 at a private pediatric dental office in a Cleveland suburb. Data were collected from each chart by 1 investigator and recorded in a database to be statistically analyzed. Nonparametric measures of association and logistic regression were used to determine differences between the presence of EM and the study variables and odds for EM. Significance level was set at P = .05. Results: Seventy-two subjects (3.8%) were found to have EM. The more medications patients were taking, either prescription or over-the-counter, the greater the likelihood of EM (P .001). Similarly, there was increased likelihood of EM with increasing numbers of medical diagnoses. Gender, oral hygiene, and behavioral status were not found to be statistically significant in the presence of EM. Conclusion: Erythema migrans was found in the records of 3.8% of children in 2 clinical facilities in the Midwest. Also, increased prevalence was found among patients with multiple health conditions in conjunction with multiple medication use. Keywords: Erythematous patches, etiology, medication use, diagnoses