Dr. Murai Éva szerk.: Parasitologia Hungarica 24. (Budapest, 1991)

predominance was remarkable in our material. A female predominance was also described by others (6,138). In children, the monosymptomatic appearance is characteristic, while complications more often develop in adults. This phenomenon can be explained by that women may rather visit a doctor with a simple "cosmetic" problem. Children are examined more thoroughly and their illness may be recognized at the early stage. The clinical picture is characteristic and may be problematic to judge in only few cases. In most of our patients, ECM was not accompanied by other symptoms, apart from a mild local pain or disaesthesia. Multiple ECM was observed in eight per cent by Âsbrink (6), and with an even greater frequency in the U.S.A. (11). In an early Hungarian study (151), multiple ECM was found in 23% of all cases. This figure decreased to half in the present study. The diagnosis of multiple ECM may sometimes be difficult, but in Lb only a few rings appear. It is important to emphasize that it is not worth to wait for serological test results in a doubtful case: the prompt response to antibiotic treatment supports the diagnosis. Two-thirds of our ECM cases were presented without any joint symptoms. General symptoms have been mentioned with varying frequency, 15-70% (6, 110, 158). High fever, rash, sore throat, cough, abdominal pain, vomiting, loss of weight have been observed (11). We did not find such symptoms. Fever was rarely observed and high fever never occurred in our cases. Although the number of complications increases with time that elapses to the therapy, those American data (145) according to which all of the untreated ECM patients would later develop arthritis are certainly not true for the Hungarian cases. In our experience, complications develop only in a small portion of the untreated ECM patients. Significantly more complications appear in seropositives than in seronegatives during the time elapsing from ECM to treatment. The risk of complication in a case of a seronegative ECM which started five months ago is not higher than that in an acute but seropositive one. Our data suggest that things are determined at the moment of infection. A similar observation was described by Steere (147): he rarely observed arthritis in cases of untreated ECM but with low antibody titer. Spontaneous recovery may take several weeks or months. In one of our patients, ECM recurred over a year. Âsbrink (6) reported an average course of ten weeks. Sixty per cent of our untreated cases recovered within one month. Lymphadenosis benigna cutis (LBC) LBC is a rare form of Lb (130). Most of our LBC patients were children. Of the two possible main localizations (breasts, earlobes) we have seen the latter one only. Of the nine patients reported by Hovmark et al. (57), only two were children. Both of them had LBC on the ears. In the elderly, LBC developed on the breasts. Mainly children with LBC in the ears were reported by Weber and Neubert (158). Spontaneous recovery may take up to one year. LBC was preceded by ECM in one, and by other major complications in two children. ECM and facial palsy appeared on the same side as LBC developed.