ro13-9904 and Acrodermatitis

Acrodermatitis chronica atrophicans is a late manifestation of European Lyme borreliosis and is characterized by high levels of borrelial IgG antibodies, slowly expanding skin redness usually beginning on distal parts of extremities, and corresponding histologic findings. It very rarely develops in children. The main prerequisite for the diagnosis is clinical suspicion. In the present article we report on two children with acrodermatitis chronica atrophicans and on the findings of a PubMed literature search on acrodermatitis chronica atrophicans in childhood, published in the past three decades.

Topics: Acrodermatitis; Administration, Intravenous; Adolescent; Borrelia; Ceftriaxone; Child; Female; Humans; Lyme Disease; Skin; Treatment Outcome

Borrelia burgdorferi is a major cause of morbidity in wooded area in western Europe and the eastern seaboard of the U.S.A. Diagnosis of late stage infection and associated disorders may be difficult and often requires an array of different diagnostic procedures. Here we report an 11-year-old girl with acrodermatitis chronica atrophicans affecting all four limbs and parts of the trunk. The diagnosis was made on the basis of clinical appearance, serological and histopathological findings, and the lesional detection of B. burgdorferi-specific gene segments by polymerase chain reaction. This very unusual, severe case illustrates that despite being a late manifestation of tick-borne B.burgdorferi infection, usually occurring in adults, acrodermatitis chronica atrophicans may already appear at a young age and may be characterized by extensive skin involvement.

Topics: Acrodermatitis; Antibodies, Bacterial; Arthralgia; Borrelia burgdorferi; Ceftriaxone; Cephalosporins; Child; Enzyme-Linked Immunosorbent Assay; Female; Humans; Immunoglobulin G; Immunoglobulin M; Lyme Disease

There are only few cases of renal pathology induced by Lyme borreliosis in the literature, as this damage is rare and uncommon in humans. This patient is the first case of minimal change glomerular disease associated with chronic Lyme borreliosis.. A 65-year-old Caucasian woman was admitted for an acute edematous syndrome related to a nephrotic syndrome. Clinical examination revealed violaceous skin lesions of the right calf and the gluteal region that occurred 2 years ago. Serological tests were positive for Lyme borreliosis and skin biopsy revealed lesions of chronic atrophic acrodermatitis. Renal biopsy showed minimal change glomerular disease. The skin lesions and the nephrotic syndrome resolved with a sequential treatment with first ceftriaxone and then corticosteroids.. We report here the first case of minimal change disease associated with Lyme borreliosis. The pathogenesis of minimal change disease in the setting of Lyme disease is discussed but the association of Lyme and minimal change disease may imply a synergistic effect of phenotypic and bacterial factors. Regression of proteinuria after a sequential treatment with ceftriaxone and corticosteroids seems to strengthen this conceivable association.

Topics: Acrodermatitis; Aged; Anti-Bacterial Agents; Ceftriaxone; Chronic Disease; Female; Glucocorticoids; Humans; Kidney; Lyme Disease; Nephrosis, Lipoid; Nephrotic Syndrome; Prednisolone; Skin

Topics: Acrodermatitis; Aged; Anti-Bacterial Agents; Atrophy; Borrelia burgdorferi Group; Ceftriaxone; Chronic Disease; Humans; Lyme Disease; Male; Skin

Topics: Acrodermatitis; Administration, Oral; Biopsy, Needle; Borrelia burgdorferi; Ceftriaxone; Child; Female; Follow-Up Studies; Humans; Immunohistochemistry; Infusions, Intravenous; Lyme Disease; Penicillin G; Risk Assessment; Severity of Illness Index; Treatment Outcome

Topics: Acrodermatitis; Anti-Bacterial Agents; Ceftriaxone; Humans; Lyme Disease; Male; Middle Aged; Recurrence; Treatment Outcome

A 60-years old female patient developed juxta-articular fibroid nodules and erythrocyanotic lesions of acrodermatitis chronica atrophicans after several tick bites. The woman was treated with ceftriaxon (Rocephin) 2 g daily parenterally without adverse reactions.

Topics: Acrodermatitis; Ceftriaxone; Elbow Joint; Erythema Chronicum Migrans; Female; Fibroma; Humans; Infusions, Intravenous; Knee Joint; Lyme Disease; Middle Aged; Skin; Skin Neoplasms

Classic variants of cutaneous borreliosis are erythema chronicum migrans (ECM), lymphadenosis benigna cutis (LBC) and acrodermatitis chronica atrophicans (ACA). Other dermatoses have been reported in the literature as possibly linked to borreliosis. A 59-year old female patient was seen in the late phases of cutaneous borreliosis with histologically confirmed ACA. In addition, prominent livedo racemosa was seen on the legs, also showing tissue changes similar to those of ACA. Borrelia burgdorferi infection was serologically confirmed by the presence of anti-IgM and anti-IgG antibodies. The clinical spectrum of late cutaneous borreliosis should be enlarged to include livedo racemosa.

Topics: Acrodermatitis; Antibodies, Bacterial; Biopsy; Borrelia burgdorferi Group; Ceftriaxone; Cephalosporins; Enzyme-Linked Immunosorbent Assay; Female; Humans; Immunoglobulin G; Immunoglobulin M; Lyme Disease; Middle Aged; Skin; Skin Diseases, Vascular; Time Factors