Acrodermatitis chronica atrophicans physical examination

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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]


Skin examination of acrodermatitis chronica atrophicans's patients include blue, red or brown discoloration, hypopigmentation, indurated plaques and wrinkles, thinning and shining of involved skin. Readily visible veins, edema, ulcers and peeling are usually found. Although the most common location of these skin changes are observed on limbs, there are some cases with facial and abdominal involvement. Peripheral neuropathy develops in 50% of patients. Physical examination of some patients may reveal ulnar bands. Moreover fibrotic nodules could be seen on bony prominences, such as tibia or ulna.

Physical Examination

Physical examination of patients with acrodermatitis chronica atrophicans is usually remarkable for skin changes such as blue-red discoloration, thinning, shinning and atrophy.

Vital Signs

Vital signs of patients with acrodermatitis chronica atrophicans is usually normal.


Acrodermatitis chronica atrophicans's skin involvement on dorsum of the hands and on the legs. [6]


  • Facial involvement is rare but may occurr.[1]










  1. 1.0 1.1 1.2 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).
  2. Kim, MyungHwa; Choi, MiSoo; Seong, GiHyun; Park, MyeongJin; Park, Minkee; Hong, SeungPhil; Park, ByungCheol (2020). "Rapidly progressing generalized morphea with high lyme disease titer". Indian Journal of Dermatology. 65 (5): 432. doi:10.4103/ijd.IJD_279_18. ISSN 0019-5154.
  3. Nadal, D; Gundelfinger, R; Flueler, U; Boltshauser, E (1988). "Acrodermatitis chronica atrophicans". Archives of Disease in Childhood. 63 (1): 72–74. doi:10.1136/adc.63.1.72. ISSN 0003-9888.
  4. 4.0 4.1 4.2 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.
  5. 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).
  6. Stanek G, Fingerle V, Hunfeld KP, Jaulhac B, Kaiser R, Krause A; et al. (2011). "Lyme borreliosis: clinical case definitions for diagnosis and management in Europe". Clin Microbiol Infect. 17 (1): 69–79. doi:10.1111/j.1469-0691.2010.03175.x. PMID 20132258.
  7. 7.0 7.1 7.2 "StatPearls". 2021. PMID 33085436 Check |pmid= value (help).
  8. Kristoferitsch, W.; Sluga, E.; Graf, M.; Partsch, H.; Neumann, R.; Stanek, G.; Budka, H. (1988). "Neuropathy Associated with Acrodermatitis Chronica Atrophicans Clinical and Morphological Features". Annals of the New York Academy of Sciences. 539 (1 Lyme Disease): 35–45. doi:10.1111/j.1749-6632.1988.tb31836.x. ISSN 0077-8923.
  9. Levy, Eve; Morruzzi, Charlotte; Barbarini, Anne; Sordet, Christelle; Cribier, Bernard; Jaulhac, Benoît; Lipsker, Dan (2012). "Clinical Images: Toe dactylitis revealing late Lyme borreliosis". Arthritis & Rheumatism. 64 (4): 1293–1293. doi:10.1002/art.34395. ISSN 0004-3591.

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