Acrodermatitis chronica atrophicans pathophysiology
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
Pathophysiology
Pathogenesis
- Acrodermatitis chronica atrophicans is one of the tertiary presentations of lyme disease.[1]
- This progressive skin process is due to the effect of chronic infection with the spirochete borrelia burgdorferi. Borrelia afzelii is the predominant pathophysiology, but may not be the exclusive, etiology of acrodermatitis chronica atrophicans. [2][3][4][1]
- Borrelia garinii, borrelia afzelii and borrelia burgdorferi (B. burgdorferi sensu lato), are all responsible and have been detected in acrodermatitis chronica atrophicans patients.[5]
- Based on a study, majority of skin biopsies from acrodermatitis chronica atrophicans patients demonstrated borrelia afzelii.[5]
Genetics
Associated Conditions
Conditions associated with acrodermatitis chronica atrophicans include:[6][2]
- Lymphocytic meningoradiculitis:
- Also known as bannwarth syndrome.
- Lymphocytic meningoradiculitis is a neurological disease which is also due to Borrelia burgdorferi infection and subsequent lyme disease.
- Symptoms such as radicular pain in cervical or lumbar regions and cranial nerve palsy (such as facial palsy) are common among patients.
- Lichen sclerosus et atrophicus
- Also called Lichen sclerosus.
- It appears as scleroderma-like skin lesions.
- It has been reported in 12% patients of a study done on 50 patients with acrodermatitis chronica atrophicans.
Gross Pathology
- In the atrophy phase of the acrodermatitis chronica atrophicans skin appears transparent with easily seen veins on gross pathology.[5][7]
Microscopic Pathology
- Light and electron microscopic study of the skin biopsy shows degeneration of the elastica and collagen fibers.[8]
- Findings from biopsies exhibit leukocytic infiltrations, plasma cells and telangiectasia. [2]
- Thinning of skin layers such as dermis and epidermis has been seen in atrophic phase. [5]
References
- ↑ 1.0 1.1 Smetanick MT, Zellis SL, Ermolovich T (2010). "Acrodermatitis chronica atrophicans: a case report and review of the literature". Cutis. 85 (5): 247–52. PMID 20540415.
- ↑ 2.0 2.1 2.2 Asbrink E, Hovmark A, Olsson I (1986). "Clinical manifestations of acrodermatitis chronica atrophicans in 50 Swedish patients". Zentralbl Bakteriol Mikrobiol Hyg A. 263 (1–2): 253–61. doi:10.1016/s0176-6724(86)80128-6. PMID 3577484.
- ↑ Hansen K, Asbrink E (1989). "Serodiagnosis of erythema migrans and acrodermatitis chronica atrophicans by the Borrelia burgdorferi flagellum enzyme-linked immunosorbent assay". J Clin Microbiol. 27 (3): 545–51. doi:10.1128/jcm.27.3.545-551.1989. PMC 267355. PMID 2715325.
- ↑ Rudenko N, Golovchenko M (2021). "Sexual Transmission of Lyme Borreliosis? The Question That Calls for an Answer". Trop Med Infect Dis. 6 (2). doi:10.3390/tropicalmed6020087. PMID 34074046 Check
|pmid=value (help). - ↑ 5.0 5.1 5.2 5.3 Picken RN, Strle F, Picken MM, Ruzic-Sabljic E, Maraspin V, Lotric-Furlan S; et al. (1998). "Identification of three species of Borrelia burgdorferi sensu lato (B. burgdorferi sensu stricto, B. garinii, and B. afzelii) among isolates from acrodermatitis chronica atrophicans lesions". J Invest Dermatol. 110 (3): 211–4. doi:10.1046/j.1523-1747.1998.00130.x. PMID 9506437.
- ↑ Khalili M, Wong RJ (2018). "Underserved Does Not Mean Undeserved: Unfurling the HCV Care in the Safety Net". Dig Dis Sci. 63 (12): 3250–3252. doi:10.1007/s10620-018-5316-9. PMC 6436636. PMID 30311153.
- ↑ Abele DC, Anders KH (1990). "The many faces and phases of borreliosis II". J Am Acad Dermatol. 23 (3 Pt 1): 401–10. doi:10.1016/0190-9622(90)70233-8. PMID 2212138.
- ↑ de Koning J, Tazelaar DJ, Hoogkamp-Korstanje JA, Elema JD (1995). "Acrodermatitis chronica atrophicans: a light and electron microscopic study". J. Cutan. Pathol. 22 (1): 23–32. PMID 7751475. Unknown parameter
|month=ignored (help)
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