ACA - acrodermatitis chronica atrophicans


The late skin disease of Lyme

The late skin manifestations are caused by
 B. garinii and B. afzelii, and are seen predominantly in Europe, not in the USA.

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 [1]. It is also found as nummular disease of the trunk and upper limbs.  Antibiotic therapy for at least 4 weeks has been recommended [2]. (Dr Mayne has found response times over 3 to 4 months treatment)

1 Asbrink E, Hovmark A, Hederstedt B: The spirochetal etiology of acrodermatitis chronica atrophicans Herxheimer.

Acta Derm Venereol 1984 , 64:506-512. PubMed Abstract


2  Mullegger RR, Glatz M: Skin manifestations of lyme borreliosis: diagnosis and management.

Am J Clin Dermatol 2008 , 9:355-368. PubMed Abstract