Lyme Disease and People of Color

Lyme Disease and People of Color

Nicole Malachowski |

In places where tickborne diseases are common, people with classic symptoms often receive prompt diagnosis and effective treatment. Unfortunately, symptoms can be missed for a variety of reasons. If under-treated or completely untreated, more persistent and difficult-to-treat symptoms can develop, becoming more serious or even fatal.

People of color often go undiagnosed/misdiagnosed at a high rate when it comes to tickborne illnesses like Lyme disease. Aside from racial bias, implicit or otherwise, in healthcare settings that can influence diagnoses and guide treatment, a lack of representation in medical literature is also impactful. In the case of Lyme disease, because there are very few pictures in biology textbooks and research materials of brown/black skin with the Lyme Erythema Migrans (EM) rash, it is often missed or identified incorrectly in Black, Hispanic, and other people of color. This rash commonly associated with Lyme disease is often called the bullseye rash because of its original presentation and identification; but it can look significantly disparate on different people. The presentation can differ even more markedly when it comes to people of color. Most people don’t talk about what a Lyme rash can look like on skin with higher melanin/pigmentation because they just don’t know. More research and training on identifying skin manifestations of Lyme disease on darker skin tones is needed to fight this tickborne illness across races and cultures.


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