Acrodermatitis chronica atrophicans physical examination: Difference between revisions
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{{CMG}}; {{AE}} {{Anahita}} | |||
==Overview== | |||
[[Skin]] [[physical examination|examination]] of [[acrodermatitis chronica atrophicans]]'s [[patients]] include blue, [[Erythema|red]] or brown discoloration, [[hypopigmentation]], [[Induration|indurated]] [[Plaque|plaques]] and [[wrinkles]], thinning and shining of involved [[skin]]. Readily visible [[veins]], [[edema]], [[ulcers]] and peeling are usually found. Although the most common location of these [[skin]] changes are observed on [[Limb (anatomy)|limbs]], there are some cases with [[face|facial]] and [[abdomen|abdominal]] involvement. [[neuropathy|Peripheral neuropathy]] develops in 50% of [[patients]]. [[Physical examination]] of some [[patients]] may reveal [[Ulna|ulnar bands]]. Moreover [[Fibrosis|fibrotic]] [[Nodule (medicine)|nodules]] could be seen on [[bone|bony]] prominences, such as [[tibia]] or [[ulna]]. | |||
==Physical Examination== | |||
[[Physical examination]] of [[patients]] with [[Acrodermatitis chronica atrophicans|acrodermatitis chronica atrophicans]] is usually remarkable for [[skin]] changes such as blue-red discoloration, thinning, shinning and [[atrophy]]. | |||
===Vital Signs=== | |||
[[Vital signs]] of [[patients]] with [[Acrodermatitis chronica atrophicans|acrodermatitis chronica atrophicans]] is usually normal. | |||
===Skin=== | |||
*The following are some of the findings in [[skin]] [[physical examination|examination]] of [[acrodermatitis chronica atrophicans]]'s [[patients]]:<ref name="pmid33550695">{{cite journal| author=Ogrinc K, Maraspin V, Lusa L, Cerar Kišek T, Ružić-Sabljić E, Strle F| title=Acrodermatitis chronica atrophicans: clinical and microbiological characteristics of a cohort of 693 Slovenian patients. | journal=J Intern Med | year= 2021 | volume= | issue= | pages= | pmid=33550695 | doi=10.1111/joim.13266 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33550695 }} </ref><ref name="KimChoi2020">{{cite journal|last1=Kim|first1=MyungHwa|last2=Choi|first2=MiSoo|last3=Seong|first3=GiHyun|last4=Park|first4=MyeongJin|last5=Park|first5=Minkee|last6=Hong|first6=SeungPhil|last7=Park|first7=ByungCheol|title=Rapidly progressing generalized morphea with high lyme disease titer|journal=Indian Journal of Dermatology|volume=65|issue=5|year=2020|pages=432|issn=0019-5154|doi=10.4103/ijd.IJD_279_18}}</ref><ref name="NadalGundelfinger1988">{{cite journal|last1=Nadal|first1=D|last2=Gundelfinger|first2=R|last3=Flueler|first3=U|last4=Boltshauser|first4=E|title=Acrodermatitis chronica atrophicans.|journal=Archives of Disease in Childhood|volume=63|issue=1|year=1988|pages=72–74|issn=0003-9888|doi=10.1136/adc.63.1.72}}</ref><ref name="Muller2012">{{cite journal|last1=Muller|first1=Kurt E.|title=Damage of Collagen and Elastic Fibres by Borrelia Burgdorferi – Known and New Clinical and Histopathological Aspects|journal=The Open Neurology Journal|volume=6|issue=1|year=2012|pages=179–186|issn=1874205X|doi=10.2174/1874205X01206010179}}</ref><ref name="pmid32512846">{{cite journal| author=Scott JD| title=Presentation of Acrodermatitis Chronica Atrophicans Rashes on Lyme Disease Patients in Canada. | journal=Healthcare (Basel) | year= 2020 | volume= 8 | issue= 2 | pages= | pmid=32512846 | doi=10.3390/healthcare8020157 | pmc=7349802 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32512846 }} </ref> | |||
**Blue, [[Erythema|red]] or brown discoloration | |||
**Darkening of [[skin]] | |||
**[[Hypopigmentation]] | |||
**[[Induration|Indurated]] [[Plaque|plaques]] | |||
**Thinning | |||
**Shining (also addressed as "cigarette paper skin") | |||
**Visible [[veins]] | |||
**[[Wrinkles]] | |||
**[[Edema|Swelling]] | |||
**Peeling | |||
**[[fibrosis|Fibrotic]] [[Nodule (medicine)|nodules]] (commonly on [[bone|bony]] prominences, such as [[ulna|ulnar]] or [[tibia|tibial]] areas) | |||
**[[Fibrosis]] | |||
**[[Ulcers]] | |||
*In rare cases [[abdomen]]'s [[skin]] is involved. | |||
[[File:Acrodermatitis chronica atrophicans.jpg|frame|center|Acrodermatitis chronica atrophicans's skin involvement on dorsum of the hands and on the legs. <ref name="pmid20132258">{{cite journal| author=Stanek G, Fingerle V, Hunfeld KP, Jaulhac B, Kaiser R, Krause A | display-authors=etal| title=Lyme borreliosis: clinical case definitions for diagnosis and management in Europe. | journal=Clin Microbiol Infect | year= 2011 | volume= 17 | issue= 1 | pages= 69-79 | pmid=20132258 | doi=10.1111/j.1469-0691.2010.03175.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20132258 }} </ref>]] | |||
===HEENT=== | |||
*[[face|Facial]] involvement is rare but may occurr.<ref name="pmid33550695">{{cite journal| author=Ogrinc K, Maraspin V, Lusa L, Cerar Kišek T, Ružić-Sabljić E, Strle F| title=Acrodermatitis chronica atrophicans: clinical and microbiological characteristics of a cohort of 693 Slovenian patients. | journal=J Intern Med | year= 2021 | volume= | issue= | pages= | pmid=33550695 | doi=10.1111/joim.13266 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33550695 }} </ref> | |||
===Neck=== | |||
*[[Neck]] [[physical examination|examination]] of [[patients]] with [[Acrodermatitis chronica atrophicans|acrodermatitis chronica atrophicans]] is usually normal. | |||
===Lungs=== | |||
*[[lung|Pulmonary]] [[physical examination|examination]] of [[patients]] with [[Acrodermatitis chronica atrophicans|acrodermatitis chronica atrophicans]] is usually normal. | |||
===Heart=== | |||
*[[Circulatory system|Cardiovascular]] [[physical examination|examination]] of [[patients]] with [[Acrodermatitis chronica atrophicans|acrodermatitis chronica atrophicans]] is usually normal. | |||
===Abdomen=== | |||
*[[Abdomen|Abdominal]] [[physical examination|examination]] of [[patients]] with [[Acrodermatitis chronica atrophicans|acrodermatitis chronica atrophicans]] is usually normal. | |||
===Back=== | |||
*[[Human back|Back]] [[physical examination|examination]] of [[patients]] with [[Acrodermatitis chronica atrophicans|acrodermatitis chronica atrophicans]] is usually normal. | |||
===Genitourinary=== | |||
*Genitourinary [[physical examination|examination]] of [[patients]] with [[Acrodermatitis chronica atrophicans|acrodermatitis chronica atrophicans]] is usually normal. | |||
===Neuromuscular=== | |||
*[[neuropathy|Peripheral neuropathy]] develops in 50% of [[patients]].<ref name="pmid33085436">{{cite journal| author=| title=StatPearls | journal= | year= 2021 | volume= | issue= | pages= | pmid=33085436 | doi= | pmc= | url= }} </ref> | |||
*The most commonly observed form of [[neuropathy|peripheral neuropathy]] is [[neuropathy|sensory polyaneuropathy]].<ref name="pmid33085436">{{cite journal| author=| title=StatPearls | journal= | year= 2021 | volume= | issue= | pages= | pmid=33085436 | doi= | pmc= | url= }} </ref><ref name="KristoferitschSluga1988">{{cite journal|last1=Kristoferitsch|first1=W.|last2=Sluga|first2=E.|last3=Graf|first3=M.|last4=Partsch|first4=H.|last5=Neumann|first5=R.|last6=Stanek|first6=G.|last7=Budka|first7=H.|title=Neuropathy Associated with Acrodermatitis Chronica Atrophicans Clinical and Morphological Features|journal=Annals of the New York Academy of Sciences|volume=539|issue=1 Lyme Disease|year=1988|pages=35–45|issn=0077-8923|doi=10.1111/j.1749-6632.1988.tb31836.x}}</ref> | |||
===Extremities=== | |||
*[[Limb (anatomy)|Extremities]] of [[patients]] with [[Acrodermatitis chronica atrophicans|acrodermatitis chronica atrophicans]] are the most common area of [[skin]] involvement.<ref name="Muller2012">{{cite journal|last1=Muller|first1=Kurt E.|title=Damage of Collagen and Elastic Fibres by Borrelia Burgdorferi – Known and New Clinical and Histopathological Aspects|journal=The Open Neurology Journal|volume=6|issue=1|year=2012|pages=179–186|issn=1874205X|doi=10.2174/1874205X01206010179}}</ref> | |||
*Moreover [[patients]] with [[Acrodermatitis chronica atrophicans|acrodermatitis chronica atrophicans]] can develop [[joint]] deformity.<ref name="pmid33550695">{{cite journal| author=Ogrinc K, Maraspin V, Lusa L, Cerar Kišek T, Ružić-Sabljić E, Strle F| title=Acrodermatitis chronica atrophicans: clinical and microbiological characteristics of a cohort of 693 Slovenian patients. | journal=J Intern Med | year= 2021 | volume= | issue= | pages= | pmid=33550695 | doi=10.1111/joim.13266 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33550695 }} </ref> | |||
*[[Physical examination]] of some [[patients]] may reveal [[Ulna|ulnar bands]]. | |||
*[[Fibrosis|Fibrotic]] [[Nodule (medicine)|nodules]] could be seen on [[bone|bony]] prominences, such as [[tibia]] or [[ulna]].<ref name="Muller2012">{{cite journal|last1=Muller|first1=Kurt E.|title=Damage of Collagen and Elastic Fibres by Borrelia Burgdorferi – Known and New Clinical and Histopathological Aspects|journal=The Open Neurology Journal|volume=6|issue=1|year=2012|pages=179–186|issn=1874205X|doi=10.2174/1874205X01206010179}}</ref> | |||
*In rare cases [[tenosynovitis]] and [[dactylitis]] have been reported.<ref name="LevyMorruzzi2012">{{cite journal|last1=Levy|first1=Eve|last2=Morruzzi|first2=Charlotte|last3=Barbarini|first3=Anne|last4=Sordet|first4=Christelle|last5=Cribier|first5=Bernard|last6=Jaulhac|first6=Benoît|last7=Lipsker|first7=Dan|title=Clinical Images: Toe dactylitis revealing late Lyme borreliosis|journal=Arthritis & Rheumatism|volume=64|issue=4|year=2012|pages=1293–1293|issn=00043591|doi=10.1002/art.34395}}</ref><ref name="pmid33085436">{{cite journal| author=| title=StatPearls | journal= | year= 2021 | volume= | issue= | pages= | pmid=33085436 | doi= | pmc= | url= }} </ref> | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category:Needs review]] | |||
[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Dermatology]] | [[Category:Dermatology]] | ||
[[Category:Insect-borne diseases]] | [[Category:Insect-borne diseases]] | ||
[[Category:Lyme disease]] | [[Category:Lyme disease]] | ||
[[Category:Zoonoses]] | [[Category:Zoonoses]] | ||
[[Category:Spirochaetes]] | [[Category:Spirochaetes]] | ||
{{WH}} | |||
{{WS}} | |||
Latest revision as of 11:15, 17 June 2021
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Anahita Deylamsalehi, M.D.[2]
Overview
Skin examination of acrodermatitis chronica atrophicans's patients include blue, red or brown discoloration, hypopigmentation, indurated plaques and wrinkles, thinning and shining of involved skin. Readily visible veins, edema, ulcers and peeling are usually found. Although the most common location of these skin changes are observed on limbs, there are some cases with facial and abdominal involvement. Peripheral neuropathy develops in 50% of patients. Physical examination of some patients may reveal ulnar bands. Moreover fibrotic nodules could be seen on bony prominences, such as tibia or ulna.
Physical Examination
Physical examination of patients with acrodermatitis chronica atrophicans is usually remarkable for skin changes such as blue-red discoloration, thinning, shinning and atrophy.
Vital Signs
Vital signs of patients with acrodermatitis chronica atrophicans is usually normal.
Skin
- The following are some of the findings in skin examination of acrodermatitis chronica atrophicans's patients:[1][2][3][4][5]
- In rare cases abdomen's skin is involved.
HEENT
Neck
- Neck examination of patients with acrodermatitis chronica atrophicans is usually normal.
Lungs
- Pulmonary examination of patients with acrodermatitis chronica atrophicans is usually normal.
Heart
- Cardiovascular examination of patients with acrodermatitis chronica atrophicans is usually normal.
Abdomen
- Abdominal examination of patients with acrodermatitis chronica atrophicans is usually normal.
Back
- Back examination of patients with acrodermatitis chronica atrophicans is usually normal.
Genitourinary
- Genitourinary examination of patients with acrodermatitis chronica atrophicans is usually normal.
Neuromuscular
- Peripheral neuropathy develops in 50% of patients.[7]
- The most commonly observed form of peripheral neuropathy is sensory polyaneuropathy.[7][8]
Extremities
- Extremities of patients with acrodermatitis chronica atrophicans are the most common area of skin involvement.[4]
- Moreover patients with acrodermatitis chronica atrophicans can develop joint deformity.[1]
- Physical examination of some patients may reveal ulnar bands.
- Fibrotic nodules could be seen on bony prominences, such as tibia or ulna.[4]
- In rare cases tenosynovitis and dactylitis have been reported.[9][7]
References
- ↑ 1.0 1.1 1.2 Ogrinc K, Maraspin V, Lusa L, Cerar Kišek T, Ružić-Sabljić E, Strle F (2021). "Acrodermatitis chronica atrophicans: clinical and microbiological characteristics of a cohort of 693 Slovenian patients". J Intern Med. doi:10.1111/joim.13266. PMID 33550695 Check
|pmid=value (help). - ↑ Kim, MyungHwa; Choi, MiSoo; Seong, GiHyun; Park, MyeongJin; Park, Minkee; Hong, SeungPhil; Park, ByungCheol (2020). "Rapidly progressing generalized morphea with high lyme disease titer". Indian Journal of Dermatology. 65 (5): 432. doi:10.4103/ijd.IJD_279_18. ISSN 0019-5154.
- ↑ Nadal, D; Gundelfinger, R; Flueler, U; Boltshauser, E (1988). "Acrodermatitis chronica atrophicans". Archives of Disease in Childhood. 63 (1): 72–74. doi:10.1136/adc.63.1.72. ISSN 0003-9888.
- ↑ 4.0 4.1 4.2 Muller, Kurt E. (2012). "Damage of Collagen and Elastic Fibres by Borrelia Burgdorferi – Known and New Clinical and Histopathological Aspects". The Open Neurology Journal. 6 (1): 179–186. doi:10.2174/1874205X01206010179. ISSN 1874-205X.
- ↑ Scott JD (2020). "Presentation of Acrodermatitis Chronica Atrophicans Rashes on Lyme Disease Patients in Canada". Healthcare (Basel). 8 (2). doi:10.3390/healthcare8020157. PMC 7349802 Check
|pmc=value (help). PMID 32512846 Check|pmid=value (help). - ↑ Stanek G, Fingerle V, Hunfeld KP, Jaulhac B, Kaiser R, Krause A; et al. (2011). "Lyme borreliosis: clinical case definitions for diagnosis and management in Europe". Clin Microbiol Infect. 17 (1): 69–79. doi:10.1111/j.1469-0691.2010.03175.x. PMID 20132258.
- ↑ 7.0 7.1 7.2 "StatPearls". 2021. PMID 33085436 Check
|pmid=value (help). - ↑ Kristoferitsch, W.; Sluga, E.; Graf, M.; Partsch, H.; Neumann, R.; Stanek, G.; Budka, H. (1988). "Neuropathy Associated with Acrodermatitis Chronica Atrophicans Clinical and Morphological Features". Annals of the New York Academy of Sciences. 539 (1 Lyme Disease): 35–45. doi:10.1111/j.1749-6632.1988.tb31836.x. ISSN 0077-8923.
- ↑ Levy, Eve; Morruzzi, Charlotte; Barbarini, Anne; Sordet, Christelle; Cribier, Bernard; Jaulhac, Benoît; Lipsker, Dan (2012). "Clinical Images: Toe dactylitis revealing late Lyme borreliosis". Arthritis & Rheumatism. 64 (4): 1293–1293. doi:10.1002/art.34395. ISSN 0004-3591.