Ueber Acrodermatitis chronica atrophicans

Herxheimer, Karl; Hartmann, Kuno

doi:10.1007/bf01948518

Cited by 22 publications

(4 citation statements)

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“…The causative bacterial agent of this disease, Borrelia burgdorferi, was first isolated and cultivated'in 1982 (1,2). With that discovery, a wide array of clinical syndromes, described in both the European and American literature since the early 20th century, could be attributed to infection by B. burgdorferi (3)(4)(5)(6).…”

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confidence: 99%

Borrelia burgdorferi is clonal: implications for taxonomy and vaccine development.

Dykhuizen

Polin

Dunn

et al. 1993

Proc. Natl. Acad. Sci. U.S.A.

158

110

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The chromosomal genes fia and p93 and the ospA gene from a linear plasmid were sequenced from up to 15 isolates of Borrelia burgdorfeni, which causes Lyme borreliosis in man. Comparison of the gene trees provides no evidence for genetic exchange between chromosomal genes, suggesting B. burgdorferi is strictly clonal. Comparison of the chromosomal gene trees with that of the plasmid-encoded ospA reveals that plasmid transfer between clones is rare. Evidence for intragenic recombination was found in only a single ospA alele. The analysis reveals three common clones and a number of rare clones that are so highly divergent that vaccines developed against one are unlikely to provide immunit to organisms from others. Consequently, an understanding of the geographic and genetic variability of B. burgdorferi will prove essential for the development of effective vaccines and programs for control.While the major clones might be regarded as different species, the clonal population structure, the geographic localization, and the widespread incidence of Lyme disease suggest that B.

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mentioning

confidence: 99%

Borrelia burgdorferi is clonal: implications for taxonomy and vaccine development.

Dykhuizen

Polin

Dunn

et al. 1993

Proc. Natl. Acad. Sci. U.S.A.

158

110

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“…In some patients, ACA follows an earlier manifestation of LB, such as erythema migrans (EM). ACA was first reported in 1883, when Buchwald described a diffuse idiopathic skin atrophy [ 1 ], named ACA in 1902 [ 2 ]. Thus, ACA was known in Europe 100 years before the recognition of LB in the United States in 1983 [ 3 , 4 ] and the first report that ACA is a manifestation of this disease [ 5 ].…”

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confidence: 99%

Acrodermatitis chronica atrophicans: clinical and microbiological characteristics of a cohort of 693 Slovenian patients

et al. 2021

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Background. Information on large groups of patients with acrodermatitis chronica atrophicans (ACA) is limited.Methods. We assessed clinical and microbiological characteristics of patients with ACA diagnosed at a single medical centre and compared findings in periods 1991-2004 vs. 2005-2018. The cohort is representative of Slovenian ACA patients.Results. We assessed 693 patients: 461 females and 232 males, with median age of 64 years. Median duration of ACA before diagnosis was 12 months. In all but 2 patients, the skin lesions were located on extremities, more often on the lower (70.0%) than the upper (45.2%), bilaterally in 42.4%. Reddish-blue discoloration, swelling, thinning and wrinkling of skin were present in 95.2%, 28.1%, 46.4% and 20.5% of patients, respectively. Overall, 64.4% of patients reported constitutional symptoms, 23.1% had local symptoms, and 20.8% had symptoms/signs of peripheral neuropathy. Nodules, arthritis, joint deformity, muscle atrophy and paresis were rare (<3%). Borreliae were isolated from 200/664 (30.1%) skin samples; 92.8% were Borrelia afzelii. B. garinii and B. burgdorferi s.s. were more often isolated from the skin of male patients (OR = 4.17) and from those with arthropathy (OR = 11.74). Patients included in the more recent period were older, complained less often of constitutional symptoms but more often of local symptoms, and more often had local swelling but less often skin atrophy and bilateral involvement, probably as a consequence of earlier diagnosis.Conclusions. ACA, typically caused by B. afzelii, usually affects older women. Clinical presentation depends on the duration of illness and probably on the Borrelia species causing the disease.

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“…Early in this century, Afzelius in Sweden (5) and Lipschutz in Austria (6) described a characteristic expanding skin lesion, which they called erythema migrans or erythema chronicum migrans. Many years later, it was recognized that erythema migrans could be followed by a chronic skin disease, acrodermatitis chronica atrophicans, which had already been described as a separate entity (7). In the 1940s, Bannwarth (8) defined a syndrome that consisted ofradicular pain followed by chronic lymphocytic meningitis and sometimes cranial or peripheral neuritis.…”

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confidence: 99%