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Our study is the first international report on cutaneous Lyme disease in Greece. Our purpose was, firstly, to assess the advisability of carrying out specific serological testing in the case of skin conditions certainly or possibly related to Borrelia, burgdorferi (Bb) and, secondly, to evaluate the necessity and efficacy of treatment. Our research was carried out between 1988 and 1991 on 68 patients suffering from cutaneous diseases generally related to Bb and 57 control subjects. Specific IgM and IgG antibodies were detected by indirect immunofluorescence assay (IFA) and titers > &frac1256; were considered as positive. All 57 control subjects were negative. Eighteen out of the 68 patients (26.5%) were positive. Five out of the eight patients (62.5%) with cutaneous diseases certainly related to Bb, and 13 out of the 60 patients (21.6%) with skin diseases possibly related to Bb, were positive. The high percentage (26.5%) in skin diseases generally related to Bb suggests that patients with all these diseases should be tested by IFA. Negative results in control patients confirm the specificity of IFA and indicate that it is unnecessary to perform this investigation in the absence of specific clinical manifestations. Even though we regard scleroderma to be a late form of cutaneous borreliosis, it shows a favorable response to therapy, whereas granuloma annulare, even after titer elimination, remains clinically unchanged. Treatment should be administered not only to patients with high titers, but must he regarded as essential in all seropositive cases with dermatoses generally related to borreliosis, in view of the possibility of a late manifestation of the disease. [ABSTRACT FROM AUTHOR]