Acrodermatitis Chronica Atrophicans

Acrodermatitis chronica atrophicans (ACA) (also known as "Herxheimer disease" and "Primary diffuse atrophy") is a skin rash indicative of the third or late stage of European Lyme borreliosis. ACA is a dermatological condition that takes a chronically progressive course and finally leads to a widespread atrophy of the skin. Involvement of the peripheral nervous system is often observed, specifically polyneuropathy. This progressive skin process is due to the effect of continuing active infection with the spirochete Borrelia afzelii. B afzelii is the predominant pathophysiology, but may not be the exclusive, etiologic agent of ACA. Borrelia garinii, has also been detected. The first record of ACA was made in 1883 in Breslau, Poland, where...