Acrodermatitis chronica atrophicans (ACA) or Herxheimer disease (according to its discoverer Karl Herxheimer) is one of the possible long-term consequences of a tick bite or a Lyme disease infection and describes progressive damage (lesions) to the skin, which can even lead to the death of tissue with others Consequential complaints are enough.
Table of Contents
- Acrodermatitis chronica atrophicans
- Acrodermatitis – symptoms
- Diagnosis of acrodermatitis
- Acrodermatitis treatment
Acrodermatitis – symptoms
Acrodermatitis is a late skin manifestation of Lyme disease and is most common in women over 40 years of age. Up to three percent of all people infected with Lyme disease in Germany develop Acrodermatitis chronica atrophicans as a late consequence. The skin damage occurs several years after the initial infection and mostly the extended side of a leg or arm is affected first. The first symptoms can also be seen on the outside of the hand and the top of the foot. In the further course, other parts of the body such as the soles of the feet and very rarely also the trunk or face can be affected.
Acrodermatitis is the result of tick-borne disease. (Image: Ralf Geithe / fotolia.com)
The first signs of acrodermatitis are slight bluish-reddish discoloration of the skin and edematous swelling with accompanying inflammation. In the further course of the so-called plasma-cellular dermatitis, the skin is increasingly damaged superficially but also subcutaneously (for example in the subcutaneous fatty tissue), which results in tissue loss (atrophy) with degeneration of the sweat glands and hair follicles and a decrease in collagen and elastic fibers. Also noticeable are so-called ulnar stripes (strip-like reddening on the forearm) or the thickening of the Achilles tendon or widening of the heel on the lower leg.
About two thirds of those affected also develop peripheral neuropathy in the corresponding extremity, which manifests itself as numbness or tingling in the limbs . There is also an accompanying Lyme arthritis with symptoms such as joint pain or swelling in the area of the joints.
Diagnosis of acrodermatitis
If acrodermatitis is suspected, the medical diagnosis is relatively reliable. However, a connection must first be established between the skin complaints and a possible Lyme disease, which can be difficult in practice and can lead to considerable delays in the diagnosis. Diagnosis is usually based on detection of the pathogen, with blood tests for antibodies against Lyme disease playing a particularly important role. Tissue samples from the skin can also be used for histological examinations to confirm the diagnosis.
Acrodermatitis treatment
Antibiotics are the means of choice for the late effects of Lyme disease in order to eliminate the pathogens and thus alleviate the symptoms. In the case of acrodermatitis without neurological involvement, for example, doxycycline therapy over 30 days can be used and with additional neurological symptoms, intravenous therapy with ceftriaxone is possible. The exact steps of the therapy must be selected by your doctor or your doctor depending on the extent of the symptoms
