Acrodermatitis Atrophicans Chronica

Histopathology and immunophenotype of acrodermatitis chronica atrophicans correlated with ospA and ospC genotypes of Borrelia species

“…Atrophy of the epidermis, band‐like subepidermal and periadnexal infiltrates and teleangiectasia as well as lymphoplasmacytic infiltrates, telangiecatsia and connective tissue changes have been emphasized already in the early descriptions . The epidermal changes observed by us are in keeping with prior observations by various authors and show a spectrum (Fig.…”

“…That prompted us to review the literature on histopathologic features in ACA beginning with early microscopic studies in 1945 and 1968 up to current investigations with immunohistochemical and molecular correlations. The results of these studies are summarized and commented in Table . In early studies, the diagnosis of ACA was based on clinicopathological correlation because no method for confirmation of the infection was available yet.…”

“…Criteria for diagnosis as they can be found in current textbooks of dermatopathology include a moderately dense superficial and deep perivascular interstitial and periadnexal infiltrate of lymphocytes and plasma cells mainly with few macrophages, neutrophils or eosinophils sometimes; vacuolar alteration with a subepidermal band‐like infiltrate; epidermis thinned with loss of rete ridges; compact orthokeratosis; melanophages in the upper part of the dermis; thick bundles of collagen and dilated vessels in the dermis . However, there is a controversy in the literature in regard to changes in the connective tissue and about overlapping features between ACA and lichen sclerosus and morphea . An intermediate stage between ACA and erythema migrans with interstitial granulomatous infiltrates has been suggested .…”

Differenzialdiagnose der Acrodermatitis chronica atrophicans unter besonderer Berücksichtigung der chronisch-venösen Insuffizienz

“…In Bisher gibt es nur wenige Arbeiten über die klinischen Differenzialdiagnosen der ACA (3,8,11,12,19), in denen jedoch keine Aussagen über die Häufigkeit von Fehldiagnosen und evtl. Konsequenzen getroffen werden.…”

“…Konsequenzen getroffen werden. Die in diesen Arbeiten angeführten Differenzialdiagnosen der ACA, die teilweise vom Stadium der Erkrankung abhängen, umfassen CVI, Phlebothrombose, Thrombophlebitis superficialis, periphere arterielle Verschlusskrankheit, Lymphödem, Sklerodermie, Lichen sclerosus et atrophicans, Akrozyanose, Altersatrophie, Kälteschaden/Erfrierung und Livedo (3,8,11,12,19). Dies stimmt gut mit den Ergebnissen unserer Studie überein.…”