Bullseye Rash Indicating Lyme Disease in a Male

Description

Posterior view of an adult male back centers on the right shoulder over the deltoid cap and lateral scapular region, where a round erythematous lesion expands concentrically in a bullseye pattern. A central red macule sits within a paler annular zone, bordered peripherally by a second erythematous ring that extends circumferentially across the posterolateral shoulder. The rash lies lateral to the vertebral column and inferior to the acromion, on otherwise normal-appearing skin without satellite lesions or diffuse dermatitis. Classic erythema migrans. Erythema migrans is the most recognizable cutaneous sign of early Lyme borreliosis after inoculation by an Ixodes tick carrying Borrelia spirochetes, and a posterior shoulder location fits a common bite site that patients may not notice until the lesion enlarges. The annular clearing helps distinguish it from simple cellulitis, contact dermatitis, and tinea corporis, while the clinical context should also prompt consideration of STARI in some regions. Timing matters: treatment during this stage can prevent disseminated infection with neurologic involvement (facial palsy, meningoradiculitis) or cardiac manifestations (atrioventricular block), and the image reinforces that erythema migrans can present without prominent systemic symptoms. Use this illustration in infectious disease and dermatology teaching modules to anchor pattern recognition of Lyme disease rash morphology, or in primary care and emergency medicine references discussing empiric doxycycline for a typical erythema migrans lesion. It also suits patient-facing education for public health campaigns on tick-bite prevention and early presentation, as well as CME materials contrasting annular erythemas in the shoulder and trunk. Anatomical accuracy verified by SciePro's Medical Advisory Board.