acrodermatitis chronica atrophicans

Last edited 05/2020 and last reviewed 05/2020

This is a feature of Stage III Lyme disease.

It is characterised by involvement of mainly the extensor surface of the extremities. Initially there is a bluish-red discolouration of the skin with oedematous swelling. This progresses to skin atrophy with wrinkles.

  • reported in 1-3% of Lyme borreliosis cases in Europe (1)
  • characterized by high levels of borrelial IgG antibodies (2)
  • very rarely develops in children
  • may present several months to years after an untreated erythema migrans
  • been postulated that does not resolve spontaneously, in contrast to most other manifestations of Lyme borreliosis
  • (1)
  • concurrent peripheral neuropathy is common, and local joint involvement may occur

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