title: [Acrodermatitis chronica atrophicans: late manifestation of Lyme borreliosis].
abstract: A 71-year-old man was referred to our outpatient clinic because of arthralgia and swelling of his right hand. He also showed a subcutaneous nodule on his left knee. A second patient, a 57-year-old woman, was referred because of painful skin of her legs. Dermatologic examination revealed erythematous livid discoloration on both feet and legs. There were reticular varices, corona flebectatia paraplantaris medialis and minimal pitting oedema. Serology tested positive in both patients for Borrelia and they both recalled tick bites. A third patient, a 73-year-old woman, was referred because of erythema and maculae located at her lower legs and positive Borrelia serology. Pathologic examination was typical for acrodermatitis chronica atrophicans, a late skin manifestation of Lyme borreliosis. In all patients, symptoms improved after treatment with doxycycline for four weeks. A lack of familiarity with this skin condition may lead to unnecessary vascular investigations and considerable delay in adequate treatment.
authors.affiliation: Rijnland ziekenhuis, Afd. Interne Geneeskunde, Leiderdorp, the Netherlands. cgkrol@hotmail.com
authors.forename: Charlotte G
authors.initials: CG
authors.lastname: Krol
authors.forename: Simone
authors.initials: S
authors.lastname: van der Geer
authors.forename: H B Bing
authors.initials: HB
authors.lastname: Thio
authors.forename: Martien J F M
authors.initials: MJ
authors.lastname: Janssen
authors.forename: Gé  J  P M
authors.initials: G
authors.lastname: Jonkers
mesh_terms: D000169:Acrodermatitis / Q000188:drug therapy / Q000209:etiology*; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004318:Doxycycline / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008193:Lyme Disease / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D004318:Doxycycline