Acrodermatitis chronica atrophicans medical therapy
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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] Raviteja Guddeti, M.B.B.S. [3]
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Overview
Antibiotic therapy is recommended in patients with acrodermatitis chronica atrophicans. Up to four weeks treatment with antibiotics such as amoxicillin, doxycycline, ceftriaxone, cefotaxime and penicillin G has been recommended for acrodermatitis chronica atrophicans's treatment.
Medical Therapy
- Antibiotic therapy is recommended in patients with acrodermatitis chronica atrophicans.[1]
- Up to four weeks treatment with antibiotics such as doxycycline, ceftriaxone and penicillin has been recommended in acute cases. However even with proper treatment, borrelia is able to remain in involved skin tissues. [2][3]
- 92% of patients in a study had significant reduction in level of antibody after proper antibiotic therapy.[4]
- In a study 72 hours of appropriate antibiotics concentration, such as penicillin and doxycycline, were not successful in diminishing motile organisms. However in the same study proper concentration of ceftriaxone was able to destroys motile organisms after 72 hours.[3]
- In vitro investigations have been revealed borrelia susceptibility to antibiotics such as erythromycin, ceftriaxone and cefotaxime. Except for erythromycin, borrelia showed susceptibility to ceftriaxone and cefotaxime also in in vivo evaluations. [5]
- Penicillin G was among antibiotics that weren't effective neither in vivo or in vitro.[5]
- Based on two case reports written in 1988, darkening of skin lesion in 2 children with acrodermatitis chronica atrophicans responded to benzylpenicillin over one week.[6]
- The following table is a summary of standard treatments for acrodermatitis chronica atrophicans:[7][8][9][10][11][12]
| Antibiotics | Route of Administration | Dose | Interval | Treatment Duration |
|---|---|---|---|---|
| Amoxicillin | Oral | 500 to 1000 mg | Three times a day | 14 to 28 days |
| Doxycycline | Oral | 100 mg | Twice a day | 14 to 28 days |
| Doxycycline | Oral | 200 mg | Once a day | 14 to 28 days |
| Ceftriaxone | Intravenous | 2000 mg | Once a day | 14 to 28 days |
| Cefotaxime | Intravenous | 2000 mg | Every 8 hours | 14 to 28 days |
| Penicillin G | Intravenous | 3 - 4 MU | Every 4 hours | 14 to 28 days |
References
- ↑ Weber K, Preac-Mursic V, Neubert U, Thurmayr R, Herzer P, Wilske B; et al. (1988). "Antibiotic therapy of early European Lyme borreliosis and acrodermatitis chronica atrophicans". Ann N Y Acad Sci. 539: 324–45. doi:10.1111/j.1749-6632.1988.tb31867.x. PMID 3056202.
- ↑ Aberer, Elisabeth; Breier, F.; Stanek, G.; Schmidt, B. (1996). "Success and failure in the treatment of acrodermatitis chronica atrophicans". Infection. 24 (1): 85–87. doi:10.1007/BF01780666. ISSN 0300-8126.
- ↑ 3.0 3.1 Kersten, A; Poitschek, C; Rauch, S; Aberer, E (1995). "Effects of penicillin, ceftriaxone, and doxycycline on morphology of Borrelia burgdorferi". Antimicrobial Agents and Chemotherapy. 39 (5): 1127–1133. doi:10.1128/AAC.39.5.1127. ISSN 0066-4804.
- ↑ . doi:10.2340/0001555574424428. Missing or empty
|title=(help) - ↑ 5.0 5.1 Mursic, V. P.; Wilske, B.; Schierz, G.; Holmburger, M.; Süß, E. (1987). "In vitro and in vivo susceptibility ofBorrelia burgdorferi". European Journal of Clinical Microbiology. 6 (4): 424–426. doi:10.1007/BF02013102. ISSN 0722-2211.
- ↑ 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.
- ↑ "StatPearls". 2021. PMID 33085436 Check
|pmid=value (help). - ↑ Flisiak R, Pancewicz S, Polish Society of Epidemiology and Infectious Diseases (2008). "[Diagnostics and treatment of Lyme borreliosis. Recommendations of Polish Society of Epidemiology and Infectious Diseases]". Przegl Epidemiol. 62 (1): 193–9. PMID 18536243.
- ↑ Pancewicz SA, Garlicki AM, Moniuszko-Malinowska A, Zajkowska J, Kondrusik M, Grygorczuk S; et al. (2015). "Diagnosis and treatment of tick-borne diseases recommendations of the Polish Society of Epidemiology and Infectious Diseases". Przegl Epidemiol. 69 (2): 309–16, 421–8. PMID 26233093.
- ↑ Moniuszko-Malinowska A, Czupryna P, Dunaj J, Pancewicz S, Garkowski A, Kondrusik M; et al. (2018). "Acrodermatitis chronica atrophicans: various faces of the late form of Lyme borreliosis". Postepy Dermatol Alergol. 35 (5): 490–494. doi:10.5114/ada.2018.77240. PMC 6232541. PMID 30429707.
- ↑ Asbrink E, Brehmer-Andersson E, Hovmark A (1986). "Acrodermatitis chronica atrophicans--a spirochetosis. Clinical and histopathological picture based on 32 patients; course and relationship to erythema chronicum migrans Afzelius". Am J Dermatopathol. 8 (3): 209–19. doi:10.1097/00000372-198606000-00005. PMID 3728879.
- ↑ Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID https://doi.org/10.1111/j.1365-2133.1994.tb04984.x Check
|pmid=value (help).