PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “ACRODERMATITIS ATROPHICANS”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 55 records · Page 3Linked to original sources
PubMed1996

Etiology of the acrodermatitis chronica atrophicans lesion in Lyme disease.

Spirochete diversity in acrodermatitis chronica atrophicans lesions in a closely defined central European site was compared to that in the local vector population, in human erythema migrans lesions, and in cerebrospinal fluid by amplifying and sequencing a segment of the gene of outer surface protein A directly from sampled tissues. Borrelia garinii, Borrelia afzelii, and Borrelia burgdorferi acutely infect human skin and invade internal tissues. Only B. afzelii, however, is associated with acrodermatitis chronica atrophicans lesions, persisting chronically where the skin has atrophied.

Acrodermatitis↗
PubMed2005

Acrodermatitis chronica atrophicans in a 15-year-old girl misdiagnosed as venous insufficiency for 6 years.

Acrodermatitis chronica atrophicans, the characteristic cutaneous manifestation of late Lyme borreliosis, typically occurs in elderly women. To our knowledge, only 4 cases of acrodermatitis chronica atrophicans in children have been described. Prompt diagnosis and treatment are important to prevent progression of disease and extracutaneous complications. We describe a 15-year-old girl with acrodermatitis chronica atrophicans of the left leg that had been misdiagnosed as chronic venous insufficiency for 6 years. Because of the long-standing disease course, skin changes expanded and progressed to marked atrophy. The correct diagnosis was finally based on clinical, histopathologic, and serologic findings. The girl was treated with oral doxycycline for 6 weeks, but her skin changes did not fully normalize. This case illustrates the possibility of acrodermatitis chronica atrophicans appearing in childhood and the difficulties in differentiating vascular disorders from acrodermatitis chronica atrophicans on the basis of the clinical appearance alone.

Acrodermatitis↗
PubMed1994

Acrodermatitis chronica atrophicans in the United States: clinical and histopathologic features of six cases.

Acrodermatitis chronica atrophicans is a chronic cutaneous disease caused by the Lyme disease spirochete Borrelia burgdorferi. Acrodermatitis chronica atrophicans is endemic in some regions of Europe but is only rarely seen in the United States. This report describes the clinical and histopathologic findings in six cases of acrodermatitis chronica atrophicans seen at the Mayo Clinic between 1912 and 1961. Histologic differences between early and late phases of the disease were observed, and multisystemic symptoms consistent with chronic Lyme disease were documented in a subset of the patients. All five patients from whom biographical data were available were European immigrants. Our data suggest that some of the first patients with Lyme disease in the United States came to the Mayo Clinic earlier in this century.

Acrodermatitis↗
PubMed1992

Lyme borreliosis presenting as acrodermatitis chronica atrophicans.

A patient is described who developed acrodermatitis chronica atrophicans, arthralgias and polyneuropathy as manifestations of Lyme borreliosis. The clinical diagnosis was confirmed by histological and serological examinations. Despite a long delay before the diagnosis was established, the patient responded very well to treatment with doxycycline.

Acrodermatitis↗
PubMed1987

Association of acrodermatitis chronica atrophicans and morphea.

A patient developed successively acrodermatitis chronica atrophicans (ACA) and localized scleroderma. ACA was demonstrated to be a tick-borne disease, whereas morphea is only suspected to be one. As morphea appeared after successful treatment of ACA, it suggests that localized scleroderma is not directly an infectious disease but might be rather the consequence of spirochetal infection.

Acrodermatitis↗
PubMed1984

[Clinical aspects and etiology of acrodermatitis chronica atrophicans].

We followed up nine patients with acrodermatitis chronica atrophicans (ACA) for an average of 2 years (6-44 months). Extradermal symptoms were observed in five patients, three of whom developed systemic signs such as fatigue or general sensitivity to cold; three suffered from cardiac symptoms; and two had joint and/or nervous system involvement. In one patient, erythema migrans and oligoarthralgia preceded the ACA. In most patients, the laboratory tests showed changes often seen in inflammatory diseases; we found an elevation of IgA, IgG and/or IgM in five patients. Using an indirect immunofluorescence test with Ixodes dammini spirochetes as antigen, the patients had more or less elevated IgG antibody titers and insignificant IgM antibody titers; similar results were obtained in some patients when an Ixodes ricinus spirochete isolated in the area of Munich was used as antigen. We believe that ACA is a chronic spirochetosis with manifestations present in the skin, joints, nervous system, and presumably in the heart.

Acrodermatitis↗
PubMed2002

Isolation of Borrelia burgdorferi sensu lato from a fibrous nodule in a patient with acrodermatitis chronica atrophicans.

A 66-year-old woman presented with a 2-year history of acrodermatitis chonica atrophicans of her left hand and associated fibrous nodules. In addition to skin changes she experienced profound fatigue, and pains and swelling of the left elbow and dorsum of the left hand. On clinical examination, typical livid-red discoloration of the skin distally from the left elbow was evident with atrophy on the dorsum of the hand. Nodules with diameters from 0.5 to 2 cm were present around the olecranon and along the ulnar region. The indirect immunofluorescent assay (IFA) without absorption in serum revealed negative borrelial IgM and positive IgG (1:512) antibody titres. Histological findings on tissue specimens were compatible with acrodermatitis chronica atrophicans and fibrous nodule tissue, respectively. Cultures in MKP medium of biopsy specimens from the involved skin and from one of the nodules were positive. Both isolates were identified as B. afzelii with concordant protein and plasmid profiles. The patient received a 3-week course of ceftriaxone (2 g daily, i.v.). Her condition progressively improved: pains and swelling vanished by the end of treatment, fibrous nodules diminished and skin lesions gradually began to fade. According to a MEDLINE literature search this is the first report of the isolation of B. burgdorferi sensu lato from a fibrous nodule in a patient with acrodermatitis chronica atrophicans.

Acrodermatitis↗
PubMed2000

Differential expression of cytokine mRNA in skin specimens from patients with erythema migrans or acrodermatitis chronica atrophicans.

Erythema migrans, the characteristic skin manifestation of acute Lyme borreliosis, is a self-limited lesion. In contrast, acrodermatitis chronica atrophicans, the typical cutaneous manifestation of late Lyme borreliosis, is a chronic skin condition. In an effort to understand pathogenic factors that lead to different outcomes in dermatoborrelioses, skin biopsy samples from 42 patients with erythema migrans and 27 patients with acrodermatitis chronica atrophicans were analyzed for mRNA expression of five pro-inflammatory cytokines (tumor necrosis factor alpha, interleukin-1 beta, interleukin-6, interferon-gamma, and interleukin-2) and two anti-inflammatory cytokines (interleukin-4 and interleukin-10) by in situ hybridization with cytokine-specific riboprobes. Among the 27 patients who had erythema migrans alone with no associated signs or symptoms, the major cytokines expressed in perivascular infiltrates of T cells and macrophages were the pro-inflammatory cytokine interferon-gamma and the anti-inflammatory cytokine interleukin-10. In the 15 erythema migrans patients who had associated signs and symptoms, including headache, elevated temperature, arthralgias, myalgias, or fatigue, a larger number of macrophages and greater expression of macrophage-derived pro-inflammatory cytokines, tumor necrosis factor alpha, interleukin-1 beta, and interleukin-6, were also found. In comparison, infiltrates of T cells and macrophages in the skin lesions of acrodermatitis chronica atrophicans patients had very little or no interferon-gamma expression. Instead, they usually expressed only the pro-inflammatory cytokine tumor necrosis factor alpha and the anti-inflammatory cytokine interleukin-4. Thus, the activation of pro-inflammatory cytokines in erythema migrans lesions, particularly interferon-gamma, seems to be important in the control of the spirochetal infection. In contrast, the restricted pattern of cytokine expression in acrodermatitis chronica atrophicans, including the lack of interferon-gamma, may be less effective in spirochetal killing, resulting in the chronicity of this skin lesion. J Invest Dermatol 115:1115-1123 2000

Acrodermatitis↗
PubMedDate not supplied

[ Usefulness of laboratory investigations for the diagnosis of acrodermatitis chronica atrophicans. ].

The authors report a clinical case of acrodermatitis chronica atrophicans in a 65 year old diabetic woman. The characteristic cutaneous lesion restricted to the dorsal aspect of the left hand has been evolved since two years, together with a progressive development of a typical Dupuytren disease. This yielded a contracture of the last 3 phalanges of the same left hand. Confirmatory techniques included the histology of the skin, the reactivity of specific-IgG antibodies showing high avidity and Western blot. Of this, the immunodominant antigens which were extracted from 3 genospecies of Borrelia sensu lato i.e. Bb sensu stricto, Bb garinii, Bb afzelii were compatible with past infection. Apart from the diabetic status which may have predisposed the patient to the development of Dupuytren disease, the authors question about the potential role of Borrelia burgdorferi in the occurrence of this associated disease.

Acrodermatitis↗
PubMed1991

A clinical, histological, and immunohistochemical comparison of acrodermatitis chronica atrophicans and morphea.

We compared 19 patients with acrodermatitis chronica atrophicans (ACA), a dermatosis caused by Borrelia burgdorferi infection, and 40 patients with morphea, a disease of heterogeneous origin where a borrelia etiology has been suggested in some cases, both clinically and histologically to define the differences between these two dermatoses. Clinically, ACA involves acral body sites with lower temperatures, is seen mostly in elderly persons, and presents as a livid discoloration that is not sharply demarcated. Morphea can be localized in embryonal structures, affects any age and body site, and exhibits extension at the periphery of the lesions. Histologically, ACA shows atrophy of collagen and elastic tissue as well as hypertrophic basophilic elastic tissue; whereas in morphea, sclerosis and polarizing elastic tissue are prominent. Graft-versus-host-like reactions may be present in both dermatoses. Immunohistochemical testing with different lymphocyte markers showed differences only in the expression of HLA-DR antigens. These conditions can be distinguished from each other on a clinical and histological basis in most cases. In 17% of morphea biopsy specimens, however, histological differentiation from ACA was not possible. Moreover, the histological pattern of morphea was not associated with a positive borrelia serology.

Acrodermatitis↗
PubMed1996

Acrodermatitis chronica atrophicans in an 11-year-old girl.

We report a case of acrodermatitis chronica atrophicans in an 11-year-old girl living in an area endemic for Lyme borreliosis. The diagnosis was first made on the basis of clinical, histopathological and serological findings. Moreover, Borrelia burgdorferi-specific DNA was amplified from lesional skin by polymerase chain reaction. Intravenous treatment with ceftriaxone (2 g once daily) for 2 weeks was initiated. The skin changes clearly responded to the therapy, and Borrelia burgdorferi-specific gene segments were no longer detectable by polymerase chain reaction. This is the first report of molecular-proven acrodermatitis chronica atrophicans in childhood. The occurrence of this late skin manifestation of Lyme borreliosis in children is reviewed.

Acrodermatitis↗
PubMed1976

Dermal vessels in acrodermatitis chronica atrophicans.

An ultrastructural investigation of two patients suffering from acrodermatitis chronica atrophicans revealed in the small dermal vessels swelling of the endothelial cells, material of probably plasmatic origin accumulated in the subendothelial area, and sleeves of basement membrane-like material on a concentric perivascular layout.

Acrodermatitis↗