Introduction to acrodermatitis chronica atrophicans


Published on

(ACA) Acrodermatitis Chronica Atrophicans, also known as Primary diffuse atrophy or Herxheimer disease is indicated by skin rashes, which is the sign of late or third stage European Lyme borreliosis

Published in: Health & Medicine
  • Be the first to comment

  • Be the first to like this

No Downloads
Total views
On SlideShare
From Embeds
Number of Embeds
Embeds 0
No embeds

No notes for slide

Introduction to acrodermatitis chronica atrophicans

  1. 1. Introduction to AcrodermatitisChronica Atrophicans
  2. 2. (ACA) Acrodermatitis Chronica Atrophicans, also known as Primary diffuse atrophy or Herxheimer disease is indicated by skin rashes, which is the sign of late or third stage European Lyme borreliosis. ACA is basically a dermatological condition that faces chronical progressive course which finally leads to widespread skin atrophy. Peripheral nervous system’s involvement is observed, mainly polyneuropathy.
  3. 3. This skin process progression is because of the effect of continuous and active infection with spirochete Borrelia afzelii. In this condition extreme rashes are caused. In the initial stage, cutaneous swelling, and bluish red discolouration is observed. This continues for several months or even years, after which atrophic phase is reached. Sclerotic skin plagues can also develop in some cases. Wrinkles starts appearing as ACA progresses.
  4. 4. Acrodermatitis Chronica Atrophicans is long standing as it may last from some to several years. It leads to immense skin atrophy in some patients. It may also limit joint mobility of lower and upper limb. If ACA in its acute inflammatory stage gets treated, then the result will be good. Physicians usually use histologic and serologic examination so as to confirm that whether or not a person is suffering from ACA.
  5. 5. This disease is most of the times unilateral but bilateral ACA is also very common. Some characteristics symptoms of Acrodermatitis Chronica Atrophicans include exaggerated pain reaction, progressive allodynia, and so on. If you suffer from any of these symptoms then it may be a case that you suffer from ACA. In such a situation, patients complain of paresthesia, spontaneous acral pain, cognitive dysfunction or dysesthesia.
  6. 6. Acrodermatitis Chronica Atrophicans begins with the inflammatory phase which is characterized by flat infiltrations whose size varies, or diffuse bluish red discoloration as well as skin edema. This condition mostly appears on at least one distal part of extremity, mainly on bony prominences extensor surfaces. ACA frequency is about 1% to 10% in Europe and these statistics vary from region to region.
  7. 7. This skin condition was first delineated by Buchwald in 1883. In 1902, Hartmann and Herxheimer described this condition as tissue paper and like cutaneous atrophy. The only type of LB is ACA in which non-spontaneous remissions occur. Moreover, the pathophysiology of ACA is not fully understood. This manifestation is caused because of the togetherness of several nonspecific reactions with specific immune response.
  8. 8. Absence of protective antibodies, weak cellular response, narrow antibody spectrum, major histocompatibility systems down-regulation on Langerhans cells are some of the conditions which are faced by patients suffering with LB. The chronicity of Acrodermatitis Chronica Atrophicans may increase due to a restricted cytokine expression pattern, including absence of interferon- gamma.
  9. 9. Autoimmune damage can occur when responses of cross-reactive antibody take part in it. It is unclear that whether autoimmune reactions, play some significant role in pathogenesis or not. Periarticular regions are favourable sites due to reduced oxygen pressure and acral skin temperature. It should be noted that timely diagnosis and treatment can help in controlling the disease from spreading further.