Lyme borreliosis is a frequent disease in Switzerland. Due to the increasing number of symptoms attributed to this infection, the diagnostic is often controversy between different specialists and is often a subject of discussion. The diagnostic of Lyme disease lays particularly on the knowledge of cutaneous signs which are the only specific. Despite recent scientific progress, microbiological diagnostic is still delicate and serological tests currently used do not differentiate between an active infection versus a serological marker. Here we describe the different clinical presentations of Lyme disease diagnosis and management procedures according to stages of evolution.