Acrodermatitis chronica atrophicans pathophysiology: Difference between revisions
Jump to navigation
Jump to search
| Line 11: | Line 11: | ||
*Based on a study, majority of [[skin]] [[biopsy|biopsies]] from [[acrodermatitis chronica atrophicans]] [[patients]] demonstrated [[borrelia afzelii]].<ref name="pmid9506437">{{cite journal| author=Picken RN, Strle F, Picken MM, Ruzic-Sabljic E, Maraspin V, Lotric-Furlan S | display-authors=etal| title=Identification of three species of Borrelia burgdorferi sensu lato (B. burgdorferi sensu stricto, B. garinii, and B. afzelii) among isolates from acrodermatitis chronica atrophicans lesions. | journal=J Invest Dermatol | year= 1998 | volume= 110 | issue= 3 | pages= 211-4 | pmid=9506437 | doi=10.1046/j.1523-1747.1998.00130.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9506437 }} </ref> | *Based on a study, majority of [[skin]] [[biopsy|biopsies]] from [[acrodermatitis chronica atrophicans]] [[patients]] demonstrated [[borrelia afzelii]].<ref name="pmid9506437">{{cite journal| author=Picken RN, Strle F, Picken MM, Ruzic-Sabljic E, Maraspin V, Lotric-Furlan S | display-authors=etal| title=Identification of three species of Borrelia burgdorferi sensu lato (B. burgdorferi sensu stricto, B. garinii, and B. afzelii) among isolates from acrodermatitis chronica atrophicans lesions. | journal=J Invest Dermatol | year= 1998 | volume= 110 | issue= 3 | pages= 211-4 | pmid=9506437 | doi=10.1046/j.1523-1747.1998.00130.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9506437 }} </ref> | ||
*[[Transmission (medicine)|Transmission]] of this [[infection]] probably occur via [[Ixodes scapularis|ixodes tick]], [[mosquito]] and [[fly|horsefly]] [[bite]].<ref name="pmid33085436">{{cite journal| author=| title=StatPearls | journal= | year= 2021 | volume= | issue= | pages= | pmid=33085436 | doi= | pmc= | url= }} </ref> | *[[Transmission (medicine)|Transmission]] of this [[infection]] probably occur via [[Ixodes scapularis|ixodes tick]], [[mosquito]] and [[fly|horsefly]] [[bite]].<ref name="pmid33085436">{{cite journal| author=| title=StatPearls | journal= | year= 2021 | volume= | issue= | pages= | pmid=33085436 | doi= | pmc= | url= }} </ref> | ||
*[[Acrodermatitis chronica atrophicans]] development is the result of [[Chronic (medical)|chronic]] [[T cell]] mediated reaction of [[immune system]] against [[borrelia]]. This [[immune system|immune reaction]] leads to infiltration of [[T cell|CD3+]] and [[T cell|CD4+ cells]] in the [[dermis]].<ref name="pmid33085436">{{cite journal| author=| title=StatPearls | journal= | year= 2021 | volume= | issue= | pages= | pmid=33085436 | doi= | pmc= | url= }} </ref> | |||
==Genetics== | ==Genetics== | ||
Revision as of 12:33, 10 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]
|
Acrodermatitis chronica atrophicans Microchapters |
|
Differentiating Acrodermatitis chronica atrophicans from other Diseases |
|---|
|
Diagnosis |
|
Treatment |
|
Case Studies |
|
Acrodermatitis chronica atrophicans pathophysiology On the Web |
|
American Roentgen Ray Society Images of Acrodermatitis chronica atrophicans pathophysiology |
|
Acrodermatitis chronica atrophicans pathophysiology in the news |
|
Blogs on Acrodermatitis chronica atrophicans pathophysiology |
|
Risk calculators and risk factors for Acrodermatitis chronica atrophicans pathophysiology |
Overview
Pathophysiology
Pathogenesis
- Acrodermatitis chronica atrophicans is one of the tertiary presentations of European lyme borreliosis.[1][2]
- This progressive skin process is due to the effect of chronic infection with the spirochete borrelia burgdorferi. Borrelia afzelii is the predominant pathophysiology, but may not be the exclusive, etiology of acrodermatitis chronica atrophicans. [3][4][5][1][2]
- Borrelia garinii, borrelia afzelii and borrelia burgdorferi (B. burgdorferi sensu lato), are all responsible and have been detected in acrodermatitis chronica atrophicans patients.[6]
- Based on a study, majority of skin biopsies from acrodermatitis chronica atrophicans patients demonstrated borrelia afzelii.[6]
- Transmission of this infection probably occur via ixodes tick, mosquito and horsefly bite.[7]
- Acrodermatitis chronica atrophicans development is the result of chronic T cell mediated reaction of immune system against borrelia. This immune reaction leads to infiltration of CD3+ and CD4+ cells in the dermis.[7]
Genetics
Associated Conditions
Conditions associated with acrodermatitis chronica atrophicans include:[8][3][9]
- Lymphocytic meningoradiculitis:
- Also known as bannwarth syndrome.
- Lymphocytic meningoradiculitis is a neurological disease which is also due to Borrelia burgdorferi infection and subsequent lyme disease.
- Symptoms such as radicular pain in cervical or lumbar regions and cranial nerve palsy (such as facial palsy) are common among patients.
- Lichen sclerosus et atrophicus
- Also called Lichen sclerosus.
- It appears as scleroderma-like skin lesions.
- It has been reported in 12% patients of a study done on 50 patients with acrodermatitis chronica atrophicans.
Gross Pathology
- In the atrophy phase of the acrodermatitis chronica atrophicans skin appears transparent with easily seen veins on gross pathology.[6][10]
- The following list are some of the findings on gross pathology:[2]
Microscopic Pathology
- Light and electron microscopic study of the skin biopsy shows degeneration of the elastica and collagen fibers.[11]
- Findings from biopsies exhibit leukocytic infiltrations, plasma cells, histiocytes and telangiectasia. [12][3]
- Thinning of skin layers such as dermis and epidermis has been seen in atrophic phase. [6][12]
- Pigmented stratum germinativum also has been reported in some biopsies.[12]
- The following are list of pathognomonic microscopic findings when atrophic phase starts:[12]
- Epidermal atrophy
- Elastin and collagen damage
- Dermal blood vessels dilation
- Perivascular plasma cell infiltration
References
- ↑ 1.0 1.1 Smetanick MT, Zellis SL, Ermolovich T (2010). "Acrodermatitis chronica atrophicans: a case report and review of the literature". Cutis. 85 (5): 247–52. PMID 20540415.
- ↑ 2.0 2.1 2.2 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). - ↑ 3.0 3.1 3.2 Asbrink E, Hovmark A, Olsson I (1986). "Clinical manifestations of acrodermatitis chronica atrophicans in 50 Swedish patients". Zentralbl Bakteriol Mikrobiol Hyg A. 263 (1–2): 253–61. doi:10.1016/s0176-6724(86)80128-6. PMID 3577484.
- ↑ Hansen K, Asbrink E (1989). "Serodiagnosis of erythema migrans and acrodermatitis chronica atrophicans by the Borrelia burgdorferi flagellum enzyme-linked immunosorbent assay". J Clin Microbiol. 27 (3): 545–51. doi:10.1128/jcm.27.3.545-551.1989. PMC 267355. PMID 2715325.
- ↑ Rudenko N, Golovchenko M (2021). "Sexual Transmission of Lyme Borreliosis? The Question That Calls for an Answer". Trop Med Infect Dis. 6 (2). doi:10.3390/tropicalmed6020087. PMID 34074046 Check
|pmid=value (help). - ↑ 6.0 6.1 6.2 6.3 Picken RN, Strle F, Picken MM, Ruzic-Sabljic E, Maraspin V, Lotric-Furlan S; et al. (1998). "Identification of three species of Borrelia burgdorferi sensu lato (B. burgdorferi sensu stricto, B. garinii, and B. afzelii) among isolates from acrodermatitis chronica atrophicans lesions". J Invest Dermatol. 110 (3): 211–4. doi:10.1046/j.1523-1747.1998.00130.x. PMID 9506437.
- ↑ 7.0 7.1 "StatPearls". 2021. PMID 33085436 Check
|pmid=value (help). - ↑ Khalili M, Wong RJ (2018). "Underserved Does Not Mean Undeserved: Unfurling the HCV Care in the Safety Net". Dig Dis Sci. 63 (12): 3250–3252. doi:10.1007/s10620-018-5316-9. PMC 6436636. PMID 30311153.
- ↑ 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.
- ↑ Abele DC, Anders KH (1990). "The many faces and phases of borreliosis II". J Am Acad Dermatol. 23 (3 Pt 1): 401–10. doi:10.1016/0190-9622(90)70233-8. PMID 2212138.
- ↑ de Koning J, Tazelaar DJ, Hoogkamp-Korstanje JA, Elema JD (1995). "Acrodermatitis chronica atrophicans: a light and electron microscopic study". J. Cutan. Pathol. 22 (1): 23–32. PMID 7751475. Unknown parameter
|month=ignored (help) - ↑ 12.0 12.1 12.2 12.3 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.
Template:WH {{WS}