[Acrodermatitis chronica atrophicans--a borreliosis!]

Area of Science:

• Dermatology
• Infectious Diseases
• Microbiology

Background:

• Acrodermatitis chronica atrophicans (ACA) is a chronic skin condition often associated with Borrelia burgdorferi infection.
• The causative agent of ACA has been historically debated, with spirochetes being implicated.

Observation:

• Spirochetes were successfully recovered from skin biopsy specimens of two ACA patients.
• Both patients reported a history consistent with a tick bite, a known vector for Borrelia burgdorferi.

Findings:

• The recovered spirochetes were identified as Borrelia burgdorferi.
• Serological analysis revealed elevated IgG antibody titers against the isolated Borrelia burgdorferi strain in both patients.

Implications:

• This study provides direct evidence linking Borrelia burgdorferi to acrodermatitis chronica atrophicans.
• Confirms the role of tick-borne spirochetes in the pathogenesis of ACA.
• Highlights the importance of serological testing and direct detection for diagnosing Lyme disease manifestations.