More on Lyme, and Skin: “Acrodermatitis Chronica Atrophicans”

For well over three years now, I have had what the doctors like to call psoriasis. I have been referred to a dermatologist, who was useless, asked no pertinent questions, and said “…here…use this cream.”. Even my PCP has sent me home with creams. These topical treatments do not work on my skin issues.

These skin issues, first appeared on my right upper arm. They then also presented on my left forearm, and upper back, at my shoulders. They can come in the form of just a little blister like dot, or a patch of what looks, and feels like dry skin. Sometimes they itch, and sometimes they don’t. They never fully heal, and sometimes, leave scars that are ugly, and thick.

I learned about ACA a few months ago, but it was mentioned in an article I read this morning, so I took that as a hint to look further. This is the article: Pathogenesis, and Clinical Manifestations of Borrelia burgdorferi

  • The third stage is usually characterized by chronic arthritis or acrodermatitis chronica atrophicans (ACA), a diffuse skin rash, and may continue for years.

I have had a little post it, sitting on my desk for months, and I keep forgetting to pass it on to my doctor. A reminder, forgotten in a pile of paperwork. I won’t forget again.

Because ACA is primarily found in older individuals, and late stage infections of BB/Lyme Disease, it is often not connected initially, because of forgotten tick bites, improper diagnosis of Lyme, and/or disbelief in Chronic, or Late Stage Lyme Disease.

Progressive allodynia (exaggerated reaction to pain) is a characteristic symptom and thus may be a clue to the diagnosis of ACA. Patients commonly report spontaneous acral pain and paresthesia or dysesthesia or cognitive dysfunction.

Read more here:  Acrodermatitis Chronica Atrophicans Clinical Presentation

Unfortunately, in order to be diagnosed with ACA, you would need to, at some point be diagnosed with Lyme Disease, or be considered to have Chronic, Late Stage Lyme. To top it all off, and much to my disappointment, the treatment for this skin disorder, is basically the same as the treatment for Lyme, that many have been denied.


Approach Considerations

The choice of treatment for acrodermatitis chronica atrophicans (ACA) depends on the coexistence of other signs or symptoms of Lyme borreliosis. One should also take into account the results of serologic tests. If not treated early, ACA can be associated with joint manifestations and persistent finger deformities.


“Borrelia burgdorferi infection was diagnosed with enzyme-linked immunosorbent assay, indirect immunofluorescence assay (titer: 1:1,024), and Western blot. Histologic examination confirmed the diagnosis of acrodermatitis chronica atrophicans”. 


Pharmacologic Therapy

If extracutaneous Lyme borreliosis signs are absent and the level of specific antibodies is low, the authors usually recommend oral doxycycline or oral amoxicillin administered over a period of 3 weeks.  READ MORE

Because the initial cause seems to be a chronic infection of LB, and also because this infection is surrounded by controversy,  and is often denied due to inaccurate testing, it again, falls on the shoulders of Lyme Literate medical providers, and patients themselves to research, and present facts to the communities involved. It seems to me, that with knowledge of ACA, we can reverse diagnose to LB, and hopefully find a treatment that works for both.

Please pass along this info to anyone who needs it. I have also posted the reference links below.


Note: The reader may notice, that some articles state, a rarity in the US, and the mention of several different strains of Borrelia. Keep this in mind. This is why many tests for Borrelia are inaccurate.

If you feel that you might have this condition, present facts, and reference material to your health care provider. We need to increase awareness.

More of my posts about skin issues, and lyme.


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