慢性萎縮性肢端皮膚炎
WordNet
- being long-lasting and recurrent or characterized by long suffering; "chronic indigestion"; "a chronic shortage of funds"; "a chronic invalid"
- of long duration; "chronic money problems" (同)continuing
- habitual; "a chronic smoker" (同)inveterate
PrepTutorEJDIC
- (病気が)長期にわたる,慢性の / 《名詞の前にのみ用いて》常習の,癖になった
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出典(authority):フリー百科事典『ウィキペディア(Wikipedia)』「2015/11/04 13:40:23」(JST)
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Acrodermatitis chronica atrophicans |
Classification and external resources |
ICD-10 |
L90.4 |
ICD-9-CM |
701.8 |
DiseasesDB |
32940 |
eMedicine |
derm/4 |
Acrodermatitis chronica atrophicans (ACA) (also known as "Herxheimer disease"[1]:1102 and "Primary diffuse atrophy"[2]:293) 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, which is the predominant pathophysiology. B. afzelii may not be the exclusive etiologic agent of ACA; Borrelia garinii has also been detected.
Contents
- 1 Presentation
- 2 Prognosis and Treatment
- 3 History
- 4 See also
- 5 References
- 6 External links
Presentation
The rash caused by ACA is most evident on the extremities. It begins with an inflammatory stage with bluish red discoloration and cutaneous swelling, and concludes several months or years later with an atrophic phase. Sclerotic skin plaques may also develop.
As ACA progresses the skin begins to wrinkle.
Prognosis and Treatment
The course of ACA is long-standing, from a few to several years, and it leads to extensive atrophy of the skin and, in some patients, to the limitation of upper and lower limb joint mobility.
The outlook is good if the acute inflammatory stage of ACA is treated adequately. The therapeutic outcome is difficult to assess in patients with the chronic atrophic phase, in which many changes are only partially reversible.
Physicians should use serologic and histologic examination to confirm the diagnosis of ACA. Treatment consists of antibiotics including doxycycline and penicillin for up to four weeks in the acute case.
History
The first record of ACA was made in 1883 in Breslau, Germany, where a physician named Alfred Buchwald first delineated it.
Herxheimer and Hartmann described it in 1902 as a "tissue paper like" cutaneous atrophy.
See also
- Lyme Disease
- Erythema Migrans
- List of cutaneous conditions
References
- ^ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 1-4160-2999-0.
- ^ James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN 0-7216-2921-0.
External links
- DermIs.net Picture of Acrodermatitis chronica atrophicans rashes
UpToDate Contents
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English Journal
- [Lyme disease acrodermitis chronica atrophicans: Misleading vascular signs.]
- Blaise S1, Fiandrino G2, Satger B3, Carpentier PH3.
- Journal des maladies vasculaires.J Mal Vasc.2014 Mar 31. pii: S0398-0499(14)00049-3. doi: 10.1016/j.jmv.2014.02.004. [Epub ahead of print]
- Lyme disease acrodermatitis chronica atrophicans is a tertiary form of Lyme borrelliosis. It occurs at least six months, but also up to several years, after a tick bite. This rare condition is probably underestimated because of the difficult diagnosis. Clinical presentations of acrodermatitis chroni
- PMID 24698204
- Genotyping of borrelia from formalin-fixed paraffin-embedded skin biopsies of cutaneous borreliosis and tick bite reactions by assays targeting the IGS-region, ospA, and OspC genes.
- Brandt FC1, Ertas B, Falk TM, Metze D, Böer-Auer A.
- The British journal of dermatology.Br J Dermatol.2014 Jan 28. doi: 10.1111/bjd.12854. [Epub ahead of print]
- BACKGROUND: Lyme borreliosis has a broad spectrum of clinical presentations involving skin, joints and nerve system. The variable manifestations have been attributed to different borrelia genospecies but genotyping required culture/native tissue. In dermatology practice, however, formalin-fixed para
- PMID 24471582
- Clinical features of 705 Borrelia burgdorferi seropositive patients in an endemic area of northern Italy.
- Stinco G1, Ruscio M2, Bergamo S1, Trotter D1, Patrone P1.
- TheScientificWorldJournal.ScientificWorldJournal.2014 Jan 16;2014:414505. doi: 10.1155/2014/414505. eCollection 2014.
- BACKGROUND: Lyme Borreliosis is a multisystemic infection caused by spirochetes of Borrelia burgdorferi sensu lato complex. The features of Lyme Borreliosis may differ in the various geographical areas, primarily between the manifestations found in America and those found in Europe and Asia.OBJECTIV
- PMID 24550705
Japanese Journal
- Lymphoproliferative responses to Borrelia burgdorferi in patients with erythema migrans, acrodermatitis chronica atrophicans, lymphadenosis benigna cutis, and morphea
- Acrodermatitis chronica atrophicans
Related Links
- Acrodermatitis chronica atrophicans (ACA) is the third or late stage of European Lyme borreliosis. [1, 2] This unusual progressive fibrosing skin process is caused by an ongoing active infection with Borrelia afzelii. First delineated in 1883, [3] it was described in 1902 as a tissue paper ...
- Pathophysiology and Etiology B afzelii is the predominant etiologic agent of ACA but may not be the sole cause. Borrelia garinii, another genospecies of the Borrelia burgdorferi sensu lato (“in the broad sense”) complex, has also been ...
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