1/8. acrodermatitis chronica atrophicans affecting all four limbs in an 11-year-old girl.borrelia burgdorferi is a major cause of morbidity in wooded area in western europe and the eastern seaboard of the U.S.A. diagnosis of late stage infection and associated disorders may be difficult and often requires an array of different diagnostic procedures. Here we report an 11-year-old girl with acrodermatitis chronica atrophicans affecting all four limbs and parts of the trunk. The diagnosis was made on the basis of clinical appearance, serological and histopathological findings, and the lesional detection of B. burgdorferi-specific gene segments by polymerase chain reaction. This very unusual, severe case illustrates that despite being a late manifestation of tick-borne B.burgdorferi infection, usually occurring in adults, acrodermatitis chronica atrophicans may already appear at a young age and may be characterized by extensive skin involvement.- - - - - - - - - - ranking = 1keywords = burgdorferi, lyme (Clic here for more details about this article) |
2/8. Novel SLC39A4 mutations in acrodermatitis enteropathica.acrodermatitis enteropathica is an autosomal recessive disease characterized by skin involvement due to defective intestinal zinc absorption. Usually, the skin lesions include erythema, erosions, and small blisters in perioral, perianal regions, and hands and feet, which develop soon after weaning from the breast. The acrodermatitis enteropathica gene has been localized to chromosomal region 8q24.3 and subsequently the SLC39A4 gene has been disclosed as the acrodermatitis enteropathica gene. SLC39A4 mutations have been demonstrated in several acrodermatitis enteropathica families, and in this study we have examined two Japanese acrodermatitis enteropathica families for SLC39A4 mutations. The mutation detection strategy consisted of polymerase chain reaction amplification of all 12 exons and flanking intronic sequences, followed by direct nucleotide sequencing. It revealed three novel mutations, 1017ins53, which creates a premature termination codon, and two mis-sense mutations, R95C and Q303H.- - - - - - - - - - ranking = 0.0040421163051517keywords = lyme (Clic here for more details about this article) |
3/8. Spirochetes in atrophic skin lesions accompanied by minimal host response in a child with lyme disease.acrodermatitis chronica atrophicans, which has rarely been observed in the united states, is a late skin manifestation of Lyme borreliosis. A 12-year-old girl who spent summers on Cape Cod presented with a 2-year history of hyperpigmentation and atrophy of the skin on the hands, wrists, and ankles. The skin biopsy specimen of an affected area showed mild dermal fibrosis, a few inflammatory cells, and spirochetes morphologically compatible with borrelia burgdorferi. An IgG antibody response to B. burgdorferi could be elicited by immunoblotting, but not by enzyme-linked immunosorbent assay. We conclude that this patient had chronic Lyme borreliosis manifested only by indolent infection of the skin.- - - - - - - - - - ranking = 0.66397192246323keywords = burgdorferi (Clic here for more details about this article) |
4/8. acrodermatitis chronica atrophicans in association with lichen sclerosus et atrophicans: tubulo-interstitial nephritis and urinary excretion of spirochete-like organisms.We report about a 38-year-old male patient with coexisting acrodermatitis chronica atrophicans, lichen sclerosus et atrophicans and recurrent diabetic metabolic disorders since 9 years. Serologically IgG antibodies against Borrelia burgdorferi could be detected. Moveless winded structures, morphologically resembling borreliae could be demonstrated in the urine sediment by dark field microscopy. Additionally a tubulo-interstitial nephritis was diagnosed by the presence of a dysmorphic hematuria, a pathological polyacrylamide gel electrophoresis and raised alpha 1- and beta 2-microglobulin in the urine. We suggest that the excreted spirochete-like structures are borreliae. They may be the putative infectious agent for the development of lichen sclerosus et atrophicans in the genital area.- - - - - - - - - - ranking = 0.60086911102865keywords = burgdorferi, borrelia (Clic here for more details about this article) |
5/8. acrodermatitis chronica atrophicans.Two cases of acrodermatitis chronica atrophicans associated with borrelia burgdorferi infection are reported; to our knowledge these are the first cases reported in children.- - - - - - - - - - ranking = 0.33198596123162keywords = burgdorferi (Clic here for more details about this article) |
6/8. acrodermatitis chronica atrophicans involving the face. Evidence for borrelia burgdorferi infection confirmed by dna amplification.In a female patient with increasing redness of the hands and face, proteins of borrelia burgdorferi were detected in a biopsy of the ear by dna amplification. Although acrodermatitis chronica atrophicans has been documented to be caused by B. burgdorferi, this is the first case with proven spirochetal presence in the skin of the head. After 2 weeks of intravenous therapy with ceftriaxone marked improvement of discoloration of the skin was noted.- - - - - - - - - - ranking = 1.9919157673897keywords = burgdorferi (Clic here for more details about this article) |
7/8. acrodermatitis chronica atrophicans: a case report and review of the literature.We report a 55-year-old woman with acrodermatitis chronica atrophicans (ACA) and a peripheral sensory neuropathy. ACA is an uncommon late cutaneous manifestation of lyme disease, which follows disseminated borrelia burgdorferi infection. This is the second published case from the U.K. since serological diagnosis has been available. In this patient the diagnosis was confirmed by serology using a sensitive enzyme-linked immunosorbent assay and immunoblotting techniques. B. burgdorferi dna was demonstrated in the affected skin using the polymerase chain reaction, although staining and cultures for the organism were negative. Recommended treatment of ACA is with oral doxycycline 100 mg twice daily for 28 days, but our patient did not respond well to this regimen. She was therefore treated with ceftriaxone intravenously for 21 days, which resulted in a rapid symptomatic and clinical response.- - - - - - - - - - ranking = 0.66801403876838keywords = burgdorferi, lyme (Clic here for more details about this article) |
8/8. acrodermatitis chronica atrophicans in an 11-year-old girl.We report a case of acrodermatitis chronica atrophicans in an 11-year-old girl living in an area endemic for Lyme borreliosis. The diagnosis was first made on the basis of clinical, histopathological and serological findings. Moreover, borrelia burgdorferi-specific dna was amplified from lesional skin by polymerase chain reaction. Intravenous treatment with ceftriaxone (2 g once daily) for 2 weeks was initiated. The skin changes clearly responded to the therapy, and borrelia burgdorferi-specific gene segments were no longer detectable by polymerase chain reaction. This is the first report of molecular-proven acrodermatitis chronica atrophicans in childhood. The occurrence of this late skin manifestation of Lyme borreliosis in children is reviewed.- - - - - - - - - - ranking = 0.67205615507354keywords = burgdorferi, lyme (Clic here for more details about this article) |