Acrodermatitis chronica atrophicans history and symptoms: Difference between revisions

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==Overview==
History of [[tick bite]], [[Lyme disease|erythema migrans]] or other [[symptoms]] of [[lyme disease]], and [[rheumatology|rheumatological]] [[symptoms]] have been presented in [[patients]] with [[acrodermatitis chronica atrophicans]]. Since there could be several years between the [[tick]] [[bite]] and development of [[skin]] lesions, absence of [[tick]] [[bite]] in [[patients]]' history never exclude the [[diagnosis]]. [[Symptoms]] and different forms of [[skin]] involvement in [[acrodermatitis chronica atrophicans]] are dependent to duration of the [[disease]]. [[Symptoms]], such as sclerotic [[skin]] changes, [[pain]] and burning, [[edema]] and [[B symptoms|constitutional symptoms]] have been observed in [[acrodermatitis chronica atrophicans]]. Half of [[patients]] with [[acrodermatitis chronica atrophicans]] experience [[symptoms]] of [[peripheral neuropathy]], such as [[paresthesia]] and [[hypesthesia]]. [[Symptoms]] of [[peripheral neuropathy]] can occure at the exact site of [[acrodermatitis chronica atrophicans]]'s lesion or at other sites. Involvement of [[leg|lower limb]] is more common compared to the [[upper limb]]. In some cases episodic [[knee]] [[joint]] [[effusion]] has been observed.
==History and Symptoms==
==History and Symptoms==
===History===
===History===
The following are some of the common findings in [[patients]]' history:<ref name="pmid3577484">{{cite journal| author=Asbrink E, Hovmark A, Olsson I| title=Clinical manifestations of acrodermatitis chronica atrophicans in 50 Swedish patients. | journal=Zentralbl Bakteriol Mikrobiol Hyg A | year= 1986 | volume= 263 | issue= 1-2 | pages= 253-61 | pmid=3577484 | doi=10.1016/s0176-6724(86)80128-6 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3577484  }} </ref><ref name="pmid6084922">{{cite journal| author=Asbrink E, Hovmark A, Hederstedt B| title=The spirochetal etiology of acrodermatitis chronica atrophicans Herxheimer. | journal=Acta Derm Venereol | year= 1984 | volume= 64 | issue= 6 | pages= 506-12 | pmid=6084922 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6084922  }} </ref>
The following are some of the common findings in [[patients]]' history:<ref name="pmid3577484">{{cite journal| author=Asbrink E, Hovmark A, Olsson I| title=Clinical manifestations of acrodermatitis chronica atrophicans in 50 Swedish patients. | journal=Zentralbl Bakteriol Mikrobiol Hyg A | year= 1986 | volume= 263 | issue= 1-2 | pages= 253-61 | pmid=3577484 | doi=10.1016/s0176-6724(86)80128-6 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3577484  }} </ref><ref name="pmid6084922">{{cite journal| author=Asbrink E, Hovmark A, Hederstedt B| title=The spirochetal etiology of acrodermatitis chronica atrophicans Herxheimer. | journal=Acta Derm Venereol | year= 1984 | volume= 64 | issue= 6 | pages= 506-12 | pmid=6084922 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6084922  }} </ref><ref name="pmid33550695">{{cite journal| author=Ogrinc K, Maraspin V, Lusa L, Cerar Kišek T, Ružić-Sabljić E, Strle F| title=Acrodermatitis chronica atrophicans: clinical and microbiological characteristics of a cohort of 693 Slovenian patients. | journal=J Intern Med | year= 2021 | volume=  | issue=  | pages=  | pmid=33550695 | doi=10.1111/joim.13266 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33550695  }} </ref><ref name="pmid33085436">{{cite journal| author=| title=StatPearls | journal= | year= 2021 | volume=  | issue=  | pages=  | pmid=33085436 | doi= | pmc= | url= }} </ref>
*[[Tick bite]]  
*[[Tick bite]]  
**Since there could be several years between the [[tick]] [[bite]] and development of [[skin]] lesions, absence of [[tick]] [[bite]] in [[patients]]' history is not meaningful alone.
**Since there could be several years between the [[tick]] [[bite]] and development of [[skin]] lesions, absence of [[tick]] [[bite]] in [[patients]]' history never exclude the [[diagnosis]].
*[[Erythema Migrans|erythema migrans]]
**Based on a study done on 693 [[patients]] with [[acrodermatitis chronica atrophicans]] approximately 85% remembered a [[tick]] [[bite]].  
*[[Lyme disease|Erythema migrans]]
**Some of the [[patients]] in a study experienced [[Erythema Migrans|erythema migrans]] 6 months to 8 years before [[acrodermatitis chronica atrophicansis]] development.
**Some of the [[patients]] in a study experienced [[Erythema Migrans|erythema migrans]] 6 months to 8 years before [[acrodermatitis chronica atrophicansis]] development.
**[[neurology|Neurological]] [[symptoms]]
*[[neurology|Neurological]] [[symptoms]]
**[[rheumatology|Rheumatological]] [[symptoms]]
*[[rheumatology|Rheumatological]] [[symptoms]]
 


===Symptoms===
===Symptoms===
*It usually involves [[Extension (kinesiology)|extensor surfaces]] of the [[Limb (anatomy)|acral regions of limbs]] beginning with an [[inflammatory]] stage (bluish red discoloration and [[edema]] followed by an atrophic phase. [[Sclerosis|Sclerotic]] [[skin]] plaques may also develop.  
*[[Symptoms]] and different forms of [[skin]] involvement in [[acrodermatitis chronica atrophicans]] are dependent to duration of the [[disease]].<ref name="pmid33550695">{{cite journal| author=Ogrinc K, Maraspin V, Lusa L, Cerar Kišek T, Ružić-Sabljić E, Strle F| title=Acrodermatitis chronica atrophicans: clinical and microbiological characteristics of a cohort of 693 Slovenian patients. | journal=J Intern Med | year= 2021 | volume=  | issue=  | pages=  | pmid=33550695 | doi=10.1111/joim.13266 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33550695  }} </ref>
*It usually involves [[Extension (kinesiology)|extensor surfaces]] of the [[Limb (anatomy)|acral regions of limbs]] beginning with an [[inflammatory]] stage (bluish red discoloration and [[edema]] followed by an [[atrophy|atrophic phase]]).  
*[[Sclerosis|Sclerotic]] [[skin]] plaques may also develop.  
*[[Acrodermatitis chronica atrophicans]] can progress and cause [[wrinkle]].
*[[Acrodermatitis chronica atrophicans]] can progress and cause [[wrinkle]].
*The following are [[symptoms]] have been observed in [[acrodermatitis chronica atrophicans]]:<ref name="pmid3577484">{{cite journal| author=Asbrink E, Hovmark A, Olsson I| title=Clinical manifestations of acrodermatitis chronica atrophicans in 50 Swedish patients. | journal=Zentralbl Bakteriol Mikrobiol Hyg A | year= 1986 | volume= 263 | issue= 1-2 | pages= 253-61 | pmid=3577484 | doi=10.1016/s0176-6724(86)80128-6 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3577484  }} </ref>
*The following are [[symptoms]] have been observed in [[acrodermatitis chronica atrophicans]]:<ref name="pmid3577484">{{cite journal| author=Asbrink E, Hovmark A, Olsson I| title=Clinical manifestations of acrodermatitis chronica atrophicans in 50 Swedish patients. | journal=Zentralbl Bakteriol Mikrobiol Hyg A | year= 1986 | volume= 263 | issue= 1-2 | pages= 253-61 | pmid=3577484 | doi=10.1016/s0176-6724(86)80128-6 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3577484  }} </ref><ref name="pmid33550695">{{cite journal| author=Ogrinc K, Maraspin V, Lusa L, Cerar Kišek T, Ružić-Sabljić E, Strle F| title=Acrodermatitis chronica atrophicans: clinical and microbiological characteristics of a cohort of 693 Slovenian patients. | journal=J Intern Med | year= 2021 | volume=  | issue=  | pages=  | pmid=33550695 | doi=10.1111/joim.13266 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33550695  }} </ref><ref name="KaminskyMaisonobe2020">{{cite journal|last1=Kaminsky|first1=Anne-Laure|last2=Maisonobe|first2=Thierry|last3=Lenglet|first3=Timothée|last4=Psimaras|first4=Dimitri|last5=Debs|first5=Rabab|last6=Viala|first6=Karine|title=Confirmed cases of Neuroborreliosis with involvement of peripheral nervous system|journal=Medicine|volume=99|issue=40|year=2020|pages=e21986|issn=0025-7974|doi=10.1097/MD.0000000000021986}}</ref><ref name="Muller2012">{{cite journal|last1=Muller|first1=Kurt E.|title=Damage of Collagen and Elastic Fibres by Borrelia Burgdorferi – Known and New Clinical and Histopathological Aspects|journal=The Open Neurology Journal|volume=6|issue=1|year=2012|pages=179–186|issn=1874205X|doi=10.2174/1874205X01206010179}}</ref><ref name="pmid32512846">{{cite journal| author=Scott JD| title=Presentation of Acrodermatitis Chronica Atrophicans Rashes on Lyme Disease Patients in Canada. | journal=Healthcare (Basel) | year= 2020 | volume= 8 | issue= 2 | pages=  | pmid=32512846 | doi=10.3390/healthcare8020157 | pmc=7349802 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32512846  }} </ref>
**[[Joint]] deformities
**Sclerotic [[skin]] lesions
**Sclerotic [[skin]] lesions
**[[Pain]]
**[[Pain]] and burning
**[[Edema]]
**[[Edema]]
**[[Wrinkles]]
**[[Peripheral neuropathy]] (develop in half of [[patients]])
***Such as [[paresthesia]] and [[hypesthesia]]
***Some [[patients]] develop [[symptoms]] related to [[peripheral neuropathy]] at the exact site of [[acrodermatitis chronica atrophicans]]'s lesion, nevertheless there are other [[patients]] that experienced these [[symptoms]] at other sites.
***Most of the times it presents as asymmetric distal sensory disturbance, which could be [[pain|painful]] or [[pain|painless]].
**[[Arthropathy]]
**[[B symptoms|Constitutional symptoms]] (such as [[fever]] and [[fatigue]])
**[[Joint]] deformities
**Band-like [[induration]] on [[Limb (anatomy)|extremities]]
*Based on a study done on 693 [[patients]] suffering from [[acrodermatitis chronica atrophicans]]:<ref name="pmid33550695">{{cite journal| author=Ogrinc K, Maraspin V, Lusa L, Cerar Kišek T, Ružić-Sabljić E, Strle F| title=Acrodermatitis chronica atrophicans: clinical and microbiological characteristics of a cohort of 693 Slovenian patients. | journal=J Intern Med | year= 2021 | volume=  | issue=  | pages=  | pmid=33550695 | doi=10.1111/joim.13266 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33550695  }} </ref>
**Involvement of [[leg|lower limb]] (70%) has been more common compared to [[upper limb]] (45.2%).
**In 42.4% of cases acral involvement occurred bilaterally.
**Only 2 among 693 [[patients]] had [[skin]] involvement on areas other than [[Limb (anatomy)|extremities]].
**Less than 3% of studied [[patients]] had [[symptoms]] such as [[Nodule (medicine)|nodule]], [[arthritis]], [[itch|itching]], [[muscle atrophy]], [[joint]] deformities and [[paresis]].
**Small fraction of [[patients]] didn't experience any [[skin]] discoloration and their main presentations were [[edema]] and [[atrophy|atrophic changes]].
*In some cases episodic [[knee]] [[joint]] [[effusion]] has been observed.<ref name="pmid32512846">{{cite journal| author=Scott JD| title=Presentation of Acrodermatitis Chronica Atrophicans Rashes on Lyme Disease Patients in Canada. | journal=Healthcare (Basel) | year= 2020 | volume= 8 | issue= 2 | pages=  | pmid=32512846 | doi=10.3390/healthcare8020157 | pmc=7349802 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32512846  }} </ref>
*In some cases [[symptoms]] such as [[Personality|personality changes]] have been reported due to involvement of central nervous system.<ref name="pmid32512846">{{cite journal| author=Scott JD| title=Presentation of Acrodermatitis Chronica Atrophicans Rashes on Lyme Disease Patients in Canada. | journal=Healthcare (Basel) | year= 2020 | volume= 8 | issue= 2 | pages=  | pmid=32512846 | doi=10.3390/healthcare8020157 | pmc=7349802 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32512846  }} </ref>


==References==
==References==

Latest revision as of 11:06, 17 June 2021

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Anahita Deylamsalehi, M.D.[2] Raviteja Guddeti, M.B.B.S. [3]

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Overview

History of tick bite, erythema migrans or other symptoms of lyme disease, and rheumatological symptoms have been presented in patients with acrodermatitis chronica atrophicans. Since there could be several years between the tick bite and development of skin lesions, absence of tick bite in patients' history never exclude the diagnosis. Symptoms and different forms of skin involvement in acrodermatitis chronica atrophicans are dependent to duration of the disease. Symptoms, such as sclerotic skin changes, pain and burning, edema and constitutional symptoms have been observed in acrodermatitis chronica atrophicans. Half of patients with acrodermatitis chronica atrophicans experience symptoms of peripheral neuropathy, such as paresthesia and hypesthesia. Symptoms of peripheral neuropathy can occure at the exact site of acrodermatitis chronica atrophicans's lesion or at other sites. Involvement of lower limb is more common compared to the upper limb. In some cases episodic knee joint effusion has been observed.

History and Symptoms

History

The following are some of the common findings in patients' history:[1][2][3][4]

Symptoms

References

  1. ↑ 1.0 1.1 Asbrink E, Hovmark A, Olsson I (1986). "Clinical manifestations of acrodermatitis chronica atrophicans in 50 Swedish patients". Zentralbl Bakteriol Mikrobiol Hyg A. 263 (1–2): 253–61. doi:10.1016/s0176-6724(86)80128-6. PMID 3577484.
  2. ↑ Asbrink E, Hovmark A, Hederstedt B (1984). "The spirochetal etiology of acrodermatitis chronica atrophicans Herxheimer". Acta Derm Venereol. 64 (6): 506–12. PMID 6084922.
  3. ↑ 3.0 3.1 3.2 3.3 Ogrinc K, Maraspin V, Lusa L, Cerar Kišek T, Ružić-Sabljić E, Strle F (2021). "Acrodermatitis chronica atrophicans: clinical and microbiological characteristics of a cohort of 693 Slovenian patients". J Intern Med. doi:10.1111/joim.13266. PMID 33550695 Check |pmid= value (help).
  4. ↑ "StatPearls". 2021. PMID 33085436 Check |pmid= value (help).
  5. ↑ Kaminsky, Anne-Laure; Maisonobe, Thierry; Lenglet, Timothée; Psimaras, Dimitri; Debs, Rabab; Viala, Karine (2020). "Confirmed cases of Neuroborreliosis with involvement of peripheral nervous system". Medicine. 99 (40): e21986. doi:10.1097/MD.0000000000021986. ISSN 0025-7974.
  6. ↑ Muller, Kurt E. (2012). "Damage of Collagen and Elastic Fibres by Borrelia Burgdorferi – Known and New Clinical and Histopathological Aspects". The Open Neurology Journal. 6 (1): 179–186. doi:10.2174/1874205X01206010179. ISSN 1874-205X.
  7. ↑ 7.0 7.1 7.2 Scott JD (2020). "Presentation of Acrodermatitis Chronica Atrophicans Rashes on Lyme Disease Patients in Canada". Healthcare (Basel). 8 (2). doi:10.3390/healthcare8020157. PMC 7349802 Check |pmc= value (help). PMID 32512846 Check |pmid= value (help).

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