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Acrodermatitis chronica atrophicans

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Acrodermatitis chronica atrophicans is a skin condition, and as the name suggests, it leads to chronic atrophy of the skin and polyneuropathy.

Bacterial infection

This progressive skin condition caused by spirochete Borrelia afzelii, and to some lesser degree, B. afzelii, and Borrelia garinii.

Clinical presentation

The skin rash is seen most commonly on extremities.


  • It begins with an inflammatory stage and later with an atrophic phase.
  • Sclerotic skin plaques may also develop.
  • ACA progresses the skin begins to wrinkle.


1)Screening test- IgM and IgG ELISA 2) If 1 is positive or there is high clinical suspicion in spite of Elisa being negative than confirmatory test - Western Blot.

Other methods

Microscopy and culture (in modified Kelly's medium) of skin biopsy or blood samples.



Treatment consists of antibiotics including doxycycline and penicillin for up to four weeks in the acute case and sometimes longer.

See also


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