Acrodermatitis chronica atrophicans medical therapy: Difference between revisions
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==Overview== | ==Overview== | ||
[[ | [[Antibiotic]] [[therapy]] is recommended in [[patients]] with [[acrodermatitis chronica atrophicans]]. Up to four weeks [[treatment]] with [[antibiotics]] such as [[amoxicillin]], [[doxycycline]], [[ceftriaxone]], [[cefotaxime]] and [[Penicillin|penicillin G]] has been recommended for [[acrodermatitis chronica atrophicans]]'s [[treatment]]. | ||
==Medical Therapy== | ==Medical Therapy== | ||
*[[Antibiotic]] [[therapy]] is recommended in [[patients]] with [[acrodermatitis chronica atrophicans]].<ref name="pmid3056202">{{cite journal| author=Weber K, Preac-Mursic V, Neubert U, Thurmayr R, Herzer P, Wilske B | display-authors=etal| title=Antibiotic therapy of early European Lyme borreliosis and acrodermatitis chronica atrophicans. | journal=Ann N Y Acad Sci | year= 1988 | volume= 539 | issue= | pages= 324-45 | pmid=3056202 | doi=10.1111/j.1749-6632.1988.tb31867.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3056202 }} </ref> | *[[Antibiotic]] [[therapy]] is recommended in [[patients]] with [[acrodermatitis chronica atrophicans]].<ref name="pmid3056202">{{cite journal| author=Weber K, Preac-Mursic V, Neubert U, Thurmayr R, Herzer P, Wilske B | display-authors=etal| title=Antibiotic therapy of early European Lyme borreliosis and acrodermatitis chronica atrophicans. | journal=Ann N Y Acad Sci | year= 1988 | volume= 539 | issue= | pages= 324-45 | pmid=3056202 | doi=10.1111/j.1749-6632.1988.tb31867.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3056202 }} </ref> | ||
*Up to four weeks [[treatment]] with [[antibiotics]] such as [[doxycycline]] and [[penicillin]] has been recommended in acute cases. | *Up to four weeks [[treatment]] with [[antibiotics]] such as [[doxycycline]], [[ceftriaxone]] and [[penicillin]] has been recommended in acute cases. However even with proper [[treatment]], [[borrelia]] is able to remain in involved [[skin]] tissues. <ref name="AbererBreier1996">{{cite journal|last1=Aberer|first1=Elisabeth|last2=Breier|first2=F.|last3=Stanek|first3=G.|last4=Schmidt|first4=B.|title=Success and failure in the treatment of acrodermatitis chronica atrophicans|journal=Infection|volume=24|issue=1|year=1996|pages=85–87|issn=0300-8126|doi=10.1007/BF01780666}}</ref><ref name="KerstenPoitschek1995">{{cite journal|last1=Kersten|first1=A|last2=Poitschek|first2=C|last3=Rauch|first3=S|last4=Aberer|first4=E|title=Effects of penicillin, ceftriaxone, and doxycycline on morphology of Borrelia burgdorferi|journal=Antimicrobial Agents and Chemotherapy|volume=39|issue=5|year=1995|pages=1127–1133|issn=0066-4804|doi=10.1128/AAC.39.5.1127}}</ref> | ||
*92% of [[patients]] in a study had significant reduction in level of [[antibody]] after proper [[antibiotic]] [[therapy]].<ref>{{cite journal|doi=10.2340/0001555574424428}}</ref> | |||
*In a study 72 hours of appropriate [[antibiotics]] concentration, such as [[penicillin]] and [[doxycycline]], were not successful in diminishing motile [[organisms]]. However in the same study proper concentration of [[ceftriaxone]] was able to destroys motile [[organisms]] after 72 hours.<ref name="KerstenPoitschek1995">{{cite journal|last1=Kersten|first1=A|last2=Poitschek|first2=C|last3=Rauch|first3=S|last4=Aberer|first4=E|title=Effects of penicillin, ceftriaxone, and doxycycline on morphology of Borrelia burgdorferi|journal=Antimicrobial Agents and Chemotherapy|volume=39|issue=5|year=1995|pages=1127–1133|issn=0066-4804|doi=10.1128/AAC.39.5.1127}}</ref> | |||
*[[In vitro]] investigations have been revealed [[borrelia]] susceptibility to [[antibiotics]] such as [[erythromycin]], [[ceftriaxone]] and [[Cefotaxime sodium|cefotaxime]]. Except for [[erythromycin]], [[borrelia]] showed susceptibility to [[ceftriaxone]] and [[Cefotaxime sodium|cefotaxime]] also in [[in vivo]] evaluations. <ref name="MursicWilske1987">{{cite journal|last1=Mursic|first1=V. P.|last2=Wilske|first2=B.|last3=Schierz|first3=G.|last4=Holmburger|first4=M.|last5=Süß|first5=E.|title=In vitro and in vivo susceptibility ofBorrelia burgdorferi|journal=European Journal of Clinical Microbiology|volume=6|issue=4|year=1987|pages=424–426|issn=0722-2211|doi=10.1007/BF02013102}}</ref> | |||
*[[Penicillin G potassium|Penicillin G]] was among [[antibiotics]] that weren't effective neither [[in vivo]] or [[in vitro]].<ref name="MursicWilske1987">{{cite journal|last1=Mursic|first1=V. P.|last2=Wilske|first2=B.|last3=Schierz|first3=G.|last4=Holmburger|first4=M.|last5=Süß|first5=E.|title=In vitro and in vivo susceptibility ofBorrelia burgdorferi|journal=European Journal of Clinical Microbiology|volume=6|issue=4|year=1987|pages=424–426|issn=0722-2211|doi=10.1007/BF02013102}}</ref> | |||
*Based on two case reports written in 1988, darkening of [[skin]] lesion in 2 [[child|children]] with [[acrodermatitis chronica atrophicans]] responded to [[Penicillin|benzylpenicillin]] over one week.<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> | |||
*The following table is a summary of standard [[treatments]] for [[acrodermatitis chronica atrophicans]]:<ref name="pmid33085436">{{cite journal| author=| title=StatPearls | journal= | year= 2021 | volume= | issue= | pages= | pmid=33085436 | doi= | pmc= | url= }} </ref><ref name="pmid18536243">{{cite journal| author=Flisiak R, Pancewicz S, Polish Society of Epidemiology and Infectious Diseases| title=[Diagnostics and treatment of Lyme borreliosis. Recommendations of Polish Society of Epidemiology and Infectious Diseases]. | journal=Przegl Epidemiol | year= 2008 | volume= 62 | issue= 1 | pages= 193-9 | pmid=18536243 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18536243 }} </ref><ref name="pmid26233093">{{cite journal| author=Pancewicz SA, Garlicki AM, Moniuszko-Malinowska A, Zajkowska J, Kondrusik M, Grygorczuk S | display-authors=etal| title=Diagnosis and treatment of tick-borne diseases recommendations of the Polish Society of Epidemiology and Infectious Diseases. | journal=Przegl Epidemiol | year= 2015 | volume= 69 | issue= 2 | pages= 309-16, 421-8 | pmid=26233093 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26233093 }} </ref><ref name="pmid30429707">{{cite journal| author=Moniuszko-Malinowska A, Czupryna P, Dunaj J, Pancewicz S, Garkowski A, Kondrusik M | display-authors=etal| title=Acrodermatitis chronica atrophicans: various faces of the late form of Lyme borreliosis. | journal=Postepy Dermatol Alergol | year= 2018 | volume= 35 | issue= 5 | pages= 490-494 | pmid=30429707 | doi=10.5114/ada.2018.77240 | pmc=6232541 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30429707 }} </ref><ref name="pmid3728879">{{cite journal| author=Asbrink E, Brehmer-Andersson E, Hovmark A| title=Acrodermatitis chronica atrophicans--a spirochetosis. Clinical and histopathological picture based on 32 patients; course and relationship to erythema chronicum migrans Afzelius. | journal=Am J Dermatopathol | year= 1986 | volume= 8 | issue= 3 | pages= 209-19 | pmid=3728879 | doi=10.1097/00000372-198606000-00005 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3728879 }} </ref><ref name="pmidhttps://doi.org/10.1111/j.1365-2133.1994.tb04984.x">{{cite journal| author=Schmoldt A, Benthe HF, Haberland G| title=Digitoxin metabolism by rat liver microsomes. | journal=Biochem Pharmacol | year= 1975 | volume= 24 | issue= 17 | pages= 1639-41 | pmid=https://doi.org/10.1111/j.1365-2133.1994.tb04984.x | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10 }} </ref> | |||
<br> | |||
{| style="border: 2px solid #4479BA; align="left" | |||
! style="width: 200px; background: #4479BA;" | {{fontcolor|#FFF|[[Antibiotics]]}} | |||
! style="width: 200px; background: #4479BA;" | {{fontcolor|#FFF|[[Route of administration|Route of Administration]]}} | |||
! style="width: 200px; background: #4479BA;" | {{fontcolor|#FFF|[[Dose]]}} | |||
! style="width: 200px; background: #4479BA;" | {{fontcolor|#FFF|Interval}} | |||
! style="width: 200px; background: #4479BA;" | {{fontcolor|#FFF|[[Treatment]] Duration}} | |||
|- | |||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" | [[Amoxicillin]] | |||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" | [[mouth|Oral]] | |||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" | 500 to 1000 mg | |||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" | Three times a day | |||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" | 14 to 28 days | |||
|- | |||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" | [[Doxycycline]] | |||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" | [[mouth|Oral]] | |||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" | 100 mg | |||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" | Twice a day | |||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" | 14 to 28 days | |||
|- | |||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" | [[Doxycycline]] | |||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" | [[mouth|Oral]] | |||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" | 200 mg | |||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" | Once a day | |||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" | 14 to 28 days | |||
|- | |||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" | [[Ceftriaxone]] | |||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" | [[Intravenous therapy|Intravenous]] | |||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" | 2000 mg | |||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" | Once a day | |||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" | 14 to 28 days | |||
|- | |||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" | [[Cefotaxime]] | |||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" | [[Intravenous therapy|Intravenous]] | |||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" | 2000 mg | |||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" | Every 8 hours | |||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" | 14 to 28 days | |||
|- | |||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" | [[Penicillin|Penicillin G]] | |||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" | [[Intravenous therapy|Intravenous]] | |||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" | 3 - 4 MU | |||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" | Every 4 hours | |||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" | 14 to 28 days | |||
|} | |||
==References== | ==References== | ||
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[[Category:Zoonoses]] | [[Category:Zoonoses]] | ||
[[Category:Spirochaetes]] | [[Category:Spirochaetes]] | ||
[[Category:Needs | [[Category:Needs review]] | ||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
Latest revision as of 11:29, 17 June 2021
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Anahita Deylamsalehi, M.D.[2] Raviteja Guddeti, M.B.B.S. [3]
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Overview
Antibiotic therapy is recommended in patients with acrodermatitis chronica atrophicans. Up to four weeks treatment with antibiotics such as amoxicillin, doxycycline, ceftriaxone, cefotaxime and penicillin G has been recommended for acrodermatitis chronica atrophicans's treatment.
Medical Therapy
- Antibiotic therapy is recommended in patients with acrodermatitis chronica atrophicans.[1]
- Up to four weeks treatment with antibiotics such as doxycycline, ceftriaxone and penicillin has been recommended in acute cases. However even with proper treatment, borrelia is able to remain in involved skin tissues. [2][3]
- 92% of patients in a study had significant reduction in level of antibody after proper antibiotic therapy.[4]
- In a study 72 hours of appropriate antibiotics concentration, such as penicillin and doxycycline, were not successful in diminishing motile organisms. However in the same study proper concentration of ceftriaxone was able to destroys motile organisms after 72 hours.[3]
- In vitro investigations have been revealed borrelia susceptibility to antibiotics such as erythromycin, ceftriaxone and cefotaxime. Except for erythromycin, borrelia showed susceptibility to ceftriaxone and cefotaxime also in in vivo evaluations. [5]
- Penicillin G was among antibiotics that weren't effective neither in vivo or in vitro.[5]
- Based on two case reports written in 1988, darkening of skin lesion in 2 children with acrodermatitis chronica atrophicans responded to benzylpenicillin over one week.[6]
- The following table is a summary of standard treatments for acrodermatitis chronica atrophicans:[7][8][9][10][11][12]
| Antibiotics | Route of Administration | Dose | Interval | Treatment Duration |
|---|---|---|---|---|
| Amoxicillin | Oral | 500 to 1000 mg | Three times a day | 14 to 28 days |
| Doxycycline | Oral | 100 mg | Twice a day | 14 to 28 days |
| Doxycycline | Oral | 200 mg | Once a day | 14 to 28 days |
| Ceftriaxone | Intravenous | 2000 mg | Once a day | 14 to 28 days |
| Cefotaxime | Intravenous | 2000 mg | Every 8 hours | 14 to 28 days |
| Penicillin G | Intravenous | 3 - 4 MU | Every 4 hours | 14 to 28 days |
References
- ↑ Weber K, Preac-Mursic V, Neubert U, Thurmayr R, Herzer P, Wilske B; et al. (1988). "Antibiotic therapy of early European Lyme borreliosis and acrodermatitis chronica atrophicans". Ann N Y Acad Sci. 539: 324–45. doi:10.1111/j.1749-6632.1988.tb31867.x. PMID 3056202.
- ↑ Aberer, Elisabeth; Breier, F.; Stanek, G.; Schmidt, B. (1996). "Success and failure in the treatment of acrodermatitis chronica atrophicans". Infection. 24 (1): 85–87. doi:10.1007/BF01780666. ISSN 0300-8126.
- ↑ 3.0 3.1 Kersten, A; Poitschek, C; Rauch, S; Aberer, E (1995). "Effects of penicillin, ceftriaxone, and doxycycline on morphology of Borrelia burgdorferi". Antimicrobial Agents and Chemotherapy. 39 (5): 1127–1133. doi:10.1128/AAC.39.5.1127. ISSN 0066-4804.
- ↑ . doi:10.2340/0001555574424428. Missing or empty
|title=(help) - ↑ 5.0 5.1 Mursic, V. P.; Wilske, B.; Schierz, G.; Holmburger, M.; Süß, E. (1987). "In vitro and in vivo susceptibility ofBorrelia burgdorferi". European Journal of Clinical Microbiology. 6 (4): 424–426. doi:10.1007/BF02013102. ISSN 0722-2211.
- ↑ 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.
- ↑ "StatPearls". 2021. PMID 33085436 Check
|pmid=value (help). - ↑ Flisiak R, Pancewicz S, Polish Society of Epidemiology and Infectious Diseases (2008). "[Diagnostics and treatment of Lyme borreliosis. Recommendations of Polish Society of Epidemiology and Infectious Diseases]". Przegl Epidemiol. 62 (1): 193–9. PMID 18536243.
- ↑ Pancewicz SA, Garlicki AM, Moniuszko-Malinowska A, Zajkowska J, Kondrusik M, Grygorczuk S; et al. (2015). "Diagnosis and treatment of tick-borne diseases recommendations of the Polish Society of Epidemiology and Infectious Diseases". Przegl Epidemiol. 69 (2): 309–16, 421–8. PMID 26233093.
- ↑ Moniuszko-Malinowska A, Czupryna P, Dunaj J, Pancewicz S, Garkowski A, Kondrusik M; et al. (2018). "Acrodermatitis chronica atrophicans: various faces of the late form of Lyme borreliosis". Postepy Dermatol Alergol. 35 (5): 490–494. doi:10.5114/ada.2018.77240. PMC 6232541. PMID 30429707.
- ↑ Asbrink E, Brehmer-Andersson E, Hovmark A (1986). "Acrodermatitis chronica atrophicans--a spirochetosis. Clinical and histopathological picture based on 32 patients; course and relationship to erythema chronicum migrans Afzelius". Am J Dermatopathol. 8 (3): 209–19. doi:10.1097/00000372-198606000-00005. PMID 3728879.
- ↑ Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID https://doi.org/10.1111/j.1365-2133.1994.tb04984.x Check
|pmid=value (help).