My LLMD thinks it’s blebbing. He thinks it happens with Lyme & Bart. It’s why he pulses 2-3 weeks apart to allow the blebbing to calm down before restarting abx.
This is what he says in his FAQ:
“They occur as part of a microbial stress response and induce immune dysfunction in the host by causing excess and abnormal stimulation which eventually results in anergy (failure of the immune system to properly recognize the infection). I believe that blebbing can occur during a Herxheimer and then again transiently upon disconuation of the antibiotics. If blebbing does occur upon cessation of antibiotics, it provides clinical evidence that the infection is still present, even if symptoms subsequently settle down, which they usually do in about a week or so after blebbing begins.”