eISSN: 2299-0046
ISSN: 1642-395X
Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii
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5/2018
vol. 35
 
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abstract:
Original paper

Acrodermatitis chronica atrophicans: various faces of the late form of Lyme borreliosis

Anna Moniuszko-Malinowska, Piotr Czupryna, Justyna Dunaj, Sławomir Pancewicz, Adam Garkowski, Maciej Kondrusik, Sambor Grygorczuk, Joanna Zajkowska

Adv Dermatol Allergol 2018; XXXV (5): 490-494
Online publish date: 2018/07/19
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Introduction
Acrodermatitis chronica atrophicans (ACA) is probably the most common late and chronic manifestation of the Lyme borreliosis seen in European patients.

Aim
To analyze epidemiological data, and to investigate the effects of treatment of patients with ACA.

Material and methods
Nine patients were included in the study. All patients had serological examinations (ELISA and Western blot) and histopathological examination of the skin lesions performed. Eight patients had PCR in the skin biopsy performed.

Results
The duration of symptoms ranged from 2 months to 2 years. In 7 patients, skin lesions were located on lower limbs, in 2 patients – in a non-typical body area – abdomen. In 1 patient, scleroderma and in 3 patients, diabetes mellitus was diagnosed. Borrelia burgdorferi DNA was detected in 25% of the skin biopsy specimens. IgG anti-B. burgdorferi specific antibodies were present in serum of all patients (confirmed by Western blot). In all cases, the diagnosis was confirmed by histopathological examination. The response to ceftriaxone therapy varied. In 5 cases, the lesions resolved completely, in others they faded.

Conclusions
Despite raising awareness of Lyme borreliosis, late forms of the disease such as ACA are still observed. Acrodermatitis chronica atrophicans skin lesions may be located in non-characteristic areas, e.g. abdominal skin. Symptoms are not irritating or painful, therefore patients do not seek medical help. The effect of antibiotic treatment varies.

keywords:

acrodermatitis chronica atrophicans, Lyme borreliosis

references:
Stanek G, Strle F. Lyme disease – European perspective. Infect Dis Clin N Am 2008; 22: 327-39.
Letrilliart L, Ragon B, Hanslik T, Flahault A. Lyme disease in France: a primary care-based prospective study. Epidemiol Infect 2005; 133: 935-42.
Rizzoli A, Hauffe H, Carpi G, et al. Lyme borreliosis in Europe. Euro Surveill 2011; 7: 16 pii: 19906.
Stanek G, Fingerle V, Hunfeld KP, et al. Lyme borreliosis: clinical case definitions for diagnosis and management in Europe. Clin Microbiol Infect 2011; 17: 69-79.
Christova I, Komitova R. Clinical and epidemiological features of Lyme borreliosis in Bulgaria. Wien Klin Wochenschr 2004; 116: 42-6.
Nygård K, Brantsaeter AB, Mehl R. Disseminated and chronic Lyme borreliosis in Norway, 1995–2004. Euro Surveill 2005; 10: 235-8.
Stinco G, Ruscio M, Bergamo S, et al. Clinical features of 705 Borrelia burgdorferi seropositive patients in an endemic area of Northern Italy. Sci World J 2014; 4: 414505.
Zajkowska J, Czupryna P, Pancewicz SA, et al. Acrodermatitis chronica atrophicans. Lancet Infect Dis 2011; 11: 800.
Müller DE, Itin PH, Büchner SA, Rufli T. Acrodermatitis chronica atrophicans involving the face. Evidence for Borrelia burgdorferi infection confirmed by DNA amplification. Dermatology 1994; 189: 430-1.
Strle F, Wormser GP, Mead P, et al. Gender disparity between cutaneous and non-cutaneous manifestations of Lyme borreliosis. PLoS One 2013; 30: e64110.
Andres C, Ziai M, Bruckbauer H, et al. Acrodermatitis chronica atrophicans in two children. Int J Dermatol 2010; 49: 180-3.
Zalaudek I, Leinweber B, Kerl H, Müllegger RR. Acrodermatitis chronica atrophicans in a 15-year-old girl misdiagnosed as venous insufficiency for 6 years. J Am Acad Dermatol 2005; 52: 1091-4.
Leslie TA, Levell NJ, Cutler SJ, et al. Acrodermatitis chronica atrophicans: a case report and review of the literature.
Br J Dermatol 1994; 131: 687-93.
Kempf W, Kazakov DV, Hübscher E, et al. Cutaneous borreliosis associated with T cell-predominant infiltrates: a diagnostic challenge. J Am Acad Dermatol 2015; 72: 683-9.
Brandt FC, Ertas B, Falk TM, et al. Histopathology and immunophenotype of acrodermatitis chronica atrophicans correlated with ospA and ospC genotypes of Borrelia species. J Cutan Pathol 2015; 42: 674-92.
Flisiak R, Pancewicz S. Diagnostics and treatment of Lyme borreliosis. Recommendations of Polish Society of Epidemiology and Infectious Diseases. Przegl Epidemiol 2008; 62: 193-9.
Pancewicz SA, Garlicki AM, Moniuszko-Malinowska A, et al. Diagnosis and treatment of tick-borne diseases recommendations of the Polish Society of Epidemiology and Infectious Diseases. Przegl Epidemiol 2015; 69: 309-16, 421-8.
Leverkus M, Finner AM, Pokrywka A. Metastatic squamous cell carcinoma of the ankle in long-standing untreated acrodermatitis chronica atrophicans. Dermatology 2008; 217: 15-8.
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