Two Unusual Cases of Diffuse Acrodermatitis Chronica Atrophicans Seronegative for Lyme Borreliosis
- 143 Downloads
Acrodermatitis chronica atrophicans (ACA) is a late cutaneous manifestation of Lyme borreliosis . In this stage of disease, serum IgG-antibodies against Borrelia burgdorferi have been detected in practically all patients examined so far [2, 3, 4]. Reported here are the cases of two patients with unusual manifestations of ACA. The histopathological pattern was consistent with ACA in both cases, but repeated serological examinations for antibodies against Borrelia burgdorferi were negative. The diagnosis was only confirmed in both cases by the detection of Borrelia burgdorferi-specific DNA using nested PCR and subsequent sequencing of the products.
ACA occurs in Europe in up to 10% of patients with untreated infection with Borrelia spp. , but it is rarely found in the USA . Currently under discussion is whether the causative Borrelia subtype is exclusively Borrelia afzelii or possibly other species such as Borrelia burgdorferi sensu stricto or Borrelia garinii. Molecular...
KeywordsLyme Disease Borrelia Burgdorferi Lyme Borreliosis Venous Insufficiency Chronic Venous Insufficiency
This work was supported by the IZKF grant A2.
- 4.Asbrink E (1985) Erythema chronicum migrans Afzelius and acrodermatitis chronica atrophicans. Early and late manifestations of Ixodes ricinus-borne Borrelia spirochetes. Acta Derm Venereol 18 (Suppl 1):1–63Google Scholar
- 5.Asbrink E, Hovmark A, Olsson I (1986) Clinical manifestations of acrodermatitis chronica atrophicans in 50 Swedish patients. Zentralbl Bakteriol Mikrobiol Hyg 263:253–261Google Scholar
- 6.Dattwyler RJ, Volkman DJ, Luft BJ, Halperin JJ (1987) Lyme disease in Europe and North America. Lancet 1:681Google Scholar
- 7.Ryffel K, Peter O, Rutti B, Suard A, Dayer E (1999) Scored antibody reactivity determined by immunoblotting shows an association between clinical manifestations and presence of Borrelia burgdorferi sensu stricto, B. garinii, B. afzelii, and B. valaisiana in humans. J Clin Microbiol 37:4086–4092PubMedGoogle Scholar
- 19.Wang P, Hilton E (2001) Contribution of HLA alleles in the regulation of antibody production in Lyme disease. Front Biosci 6:10–16Google Scholar