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The erythema migrans rash is classically 5 to  cm in diameter, appearing as an annular homogenous erythema (59%), central erythema (30%), central clearing (9%), or central purpura (2%). [6] Because of the "bull's-eye" description to describe the Lyme disease rash, the condition commonly called ringworm is sometimes confused with Lyme disease. [6] Uncommonly, EM may be less than 5 cm in diameter . [7] Multiple painless EM rashes may occur, indicating disseminated infection.



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