title: Acrodermatitis chronica atrophicans affecting all four limbs in an 11-year-old girl.
abstract: 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.
authors.affiliation: Department of Dermatology and Venereology, Charles University, 2nd Medical School, Motol University Hospital, V Uvalu 84, 15006 Prague, Czech Republic.
authors.forename: I
authors.initials: I
authors.lastname: Brzonova
authors.forename: A
authors.initials: A
authors.lastname: Wollenberg
authors.forename: J C
authors.initials: JC
authors.lastname: Prinz
mesh_terms: D000169:Acrodermatitis / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology*; D000907:Antibodies, Bacterial / Q000097:blood; D018771:Arthralgia / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology*; D025065:Borrelia burgdorferi / Q000276:immunology; D002443:Ceftriaxone / Q000627:therapeutic use; D002511:Cephalosporins / Q000627:therapeutic use; D002648:Child; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D008193:Lyme Disease / Q000150:complications* / Q000188:drug therapy / Q000276:immunology
chemical_list: D000907:Antibodies, Bacterial; D002511:Cephalosporins; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D002443:Ceftriaxone