Purpose: This study presents a rare skin manifestation of Lyme borreliosis, specifically affecting the areola in a child in the absence of a history of a tick bite or erythema migrans.  Case report: A 9-year-old boy presented with symptomless erythematous swelling of the breast areola for one month. Initial treatment for gynecomastia and then mastitis proved ineffective. A biopsy was performed, with histological findings revealing lymphocytoma, likely stemming from an insect bite. Serology for Borrelia burgdorferi was positive. Following a two-week course of oral amoxicillin, the lesion completely resolved.  Conclusion: The consideration of Lyme disease should be a component of the differential diagnosis of skin lesions localised in typical areas, particularly in patients living in endemic regions.