ACA - acrodermatitis
The late skin disease of Lyme
Acrodermatitis chronica atrophicans is caused by B. afzelii. It is characterised as a blue to red coloured rash
with skin atrophy predominantly at the extremities . It is also found as nummular disease of the
trunk and upper limbs. Antibiotic
therapy for at least 4 weeks has been recommended . (Dr Mayne has found response times over 3 to 4
1 Asbrink E, Hovmark A,
Hederstedt B: The
spirochetal etiology of acrodermatitis chronica atrophicans Herxheimer.
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2 Mullegger RR, Glatz M: Skin
manifestations of lyme borreliosis: diagnosis and management.
J Clin Dermatol 2008
, 9:355-368. PubMed