To the Editor.— In view of recent reports in the United States of erythema chronicum migrans associated with Lyme arthritis 1 and the finding that erythema chronicum migrans can antedate the arthritis by months, and that this arthritis can be recurrent, I am interested in the follow-up of the patient reported by Naversen and Gardner. 2 Steere and his colleagues have noted that the European studies have not mentioned arthritis in the patients. But since the arthritis onset may be many months after the skin lesions have cleared, it's possible that the association may not always be made.