Borrelia burgdorferi, a Gram-negative, spiral-shaped bacterium transmitted to humans via tick bites, is the etiologic agent of borreliosis (Lyme disease) with diverse clinical manifestations. There are several types of pathological lesions in the course of Lyme disease: inflammatory, atrophic and sclerotic ones. Recent studies suggest a possible association between localized scleroderma, lichen sclerosus and Borrelia burgdorferi. A clinical similarity between late skin manifestation acrodermatitis chronica atrophicans, lichen sclerosis and morphea was noted. Studies showing regression of skin lesions in patients with localized scleroderma treated with targeted antibiotic therapy against Borrelia provide evidence for the role of the infection in the pathogenesis of morphea. The role of Borrelia burgdorferi infection in the complex pathogenesis of systemic scleroderma is still controversial. This article discusses the results of studies involving Borrelia infection in the pathogenesis of scleroderma and some dermatological disorders and describes various skin changes of borreliosis.