Lyme disease is a tick-borne zoonosis caused by Borrelia burgdorferi. A causative organism is transmitted via tick bite, Ixodes ricinus in Europe and neighboring parts of North Africa, and Ixodes scapularis and Ixodes pacificus on the west coast of North America. Erythema chronicum migrans is the first, the most common, and the most specific clinical manifestation and a defining criterion for Lyme disease.1