Acrodermatitis chronica atrophicans natural history, complications and prognosis

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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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The course of acrodermatitis chronica atrophicans is chronic and could lasts for several years and it can progress slowly overtime. It has been estimated that mean duration of acrodermatitis chronica atrophicans before diagnosis is approximately 12 months, based on a study. It usually start on one extremity and can spread and involve extensor surfaces of the acral regions of limbs. Acrodermatitis chronica atrophicans has a biphasic manner. In first phase (the inflammatory phase) skin changes appear as blue and red discoloration with boggy infiltration. These inflammatory skin lesions can become atrophic without treatment (atrophic phase). Based on two studies, 55% and 66% of patients with acrodermatitis chronica atrophicans have at least one history of tick bite, while others may never remember such an accident. One fifth of patients in a study experienced erythema migrans 6 months to 8 years before acrodermatitis chronica atrophicans development. Superimposed bacterial infection, sclerotic skin changes, malignancies, arthropathy and peripheral neuropathy are some of the common complications of acrodermatitis chronica atrophicansis. In contrast to other skin manifestations of borrelia infection, acrodermatitis chronica atrophicans doesn't heal without treatment and can lead to extensive atrophy of skin and limitations of upper and lower limb joint mobility. The general pognosis is good with proper and rapid treatment in acute inflammatory stage of acrodermatitis chronica atrophicans. Nevertheless late treatment can cause some irreversible changes.

Natural History, Complications, and Prognosis

Natural History




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