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[Extensive acrodermatitis chronica atrophicans involving the face]
J Schmidli1, T Hunziker, L Zala
1Dermatologische Universitätsklinik Bern.
Summary
A rare case of extensive acrodermatitis chronica atrophicans with facial involvement in an elderly woman showed significant improvement with oral aminopenicillin therapy over four weeks.
Area of Science:
- Dermatology
- Immunology
- Infectious Diseases
Background:
- Acrodermatitis chronica atrophicans (ACA) is a late manifestation of Borrelia burgdorferi infection.
- Facial involvement in ACA is uncommon, particularly in elderly patients.
- Potential links between ACA, immunodeficiency, and malignancy warrant further investigation.
Observation:
- An 81-year-old female presented with extensive ACA, notably involving the face.
- The patient had a history suggestive of an immunodeficiency state and multiple malignancies.
- The unusual presentation prompted evaluation for underlying systemic conditions.
Findings:
- Oral aminopenicillin therapy for 4 weeks resulted in significant clearance of cutaneous lesions.
- The treatment response suggests a potential role for bacterial infection in this patient's ACA.
- The patient's immunodeficiency and malignancy status may have influenced the disease presentation and progression.
Implications:
- This case highlights the importance of considering ACA even with atypical facial involvement in elderly patients.
- Successful antibiotic treatment underscores the need for prompt diagnosis and management of Lyme disease.
- Further research is needed to elucidate the complex interplay between ACA, immunodeficiency, and malignancy.