This case serves to underscore several clinical points. Firstly, Lyme borreliosis may present by mimicking a malignancy. Secondly, a previous episode of borrelial infection may not confer immunity. Reinfection is uncommon, but is more likely to occur in patients whose previous episode was promptly treated rather than in those with longstanding infection, who have a well‐developed antibody response before treatment.5 Thirdly, patients may not specifically recall a tick bite. Thus, it is important that a history of tick exposure risk, which may be residential, occupational or recreational, is sought from patients. Finally, Beevor’s sign has a useful localisation value