
Erythema migrans (EM) is the hallmark early skin rash of Lyme disease, appearing as a red, expanding lesion (often 5cm+) at the site of a tick bite, sometimes forming a "bull's-eye" pattern with central clearing, though it can also look like a solid red patch or bruise, especially on dark skin. It typically develops days to weeks after infection, signifies an active Borrelia bacterial infection, and requires prompt antibiotic treatment, as it's the first stage of Lyme disease.