acrodermatitis chronica atrophicans. 57-year-old female patient. skin changes existing for five years now, clearly increasing for half a year, discoloured red-blueish in cold weather. large, blurredly limited, symmetrical erythema (completely anaemic). the skin surface is wrinkled in the breast area (atrophic), otherwise smooth. some splatter-like white discolorations.
Acrodermatitis chronica atrophicans. livid, blurred, variable coloured erythema of the left hand in comparison to the healthy right hand. skin atrophically shiny, hyperesthetic.
Acrodermatitis chronica atrophicans: livid, blurred, changeable colored erythema of the left hand compared to the healthy right hand. skin atrophically shiny, hyperesthetic. positive borrelia serology!
Acrodermatitis chronica atrophicans (detailed picture): wrinkled, shiny atrophy of the skin.
Acrodermatitis chronica atrophicans. general view: Livid, unscnarfly limited, changeably coloured erythema on the left hand. skin atrophically shiny, hyperesthetic, in places a fine-lamellar scaling.
Acrodermatitis chronica atrophicans. detail view: livid, unscnarfly limited, changeably coloured erythema on the left hand. skin atrophically shiny, hyperesthetic, in places a fine-lamellar scaling.
Acrodermatitis chronica atrophicans: Detail: livid, unscnarf limited, changeable colored erythema on the left hand; skin wrinkled atrophic, shiny, hyperesthetic
Acrodermatitis chronica atrophicans: Livid erythema on the back of the right hand and nail dystrophies in a 78-year-old female patient with confirmed neuroborreliosis 6 years ago. Cushion-like (pernion-like) plaques on the fingers. Persistent pain in the carpal and interphalangeal joints.
Acrodermatitis chronica atrophicans: extensive, oedematous, tender red erythema as well as flaccid atrophy with cigarette-paper-like folding of the skin on the right hand of a 77-year-old woman. For 2 years there has also been joint pain in both hands and both shoulder joints as well as gait insecurity with proven neuroborreliosis. The fingernails are partly dystrophic (see stripy leukonychia) and partly no longer firmly connected to the nail bed.
Acrodermatitis chronica atrophicans. general view: livid, unscnarf limited, brownish-red spots on the left hand. skin in the area of the ball of the thumb atropical, finely wrinkled, with fine-lamellar scaling.
Acrodermatitis chronica atrophicans. encircles the protruding atropical skin in the area of the ball of the thumb (compare normal skin above the hypothenar). conspicuous fine wrinkles; fine-lamellar scaling. blurred brown spots on the wrist.
acrodermatitis chronica arophicans. early stage of acrodermatitis chronica atrophicans with still (clearly) recognizable border of the erythema chronicum migrans (proximal thigh). the lower half of the lower leg is clearly more strongly reddened, flat doughy indurated. no painfulness. no painful lymphadenitis. still (!) no atrophy of the surface epithelium detectable.
Acrodermatitis chronica atrophicans: Symptoms existing for 1 year with an acral accentuated, inhomogeneous, blurred, edematous, red, rough swelling on the back of the right foot and extending to the lower leg in a 70 year old female patient.
acrodermatitis chronica atrophicans: 69-year-old woman. for 4 months right lower leg flat livid-red. at the beginning somewhat edematous. not overheated. subjectively symptomless except for slight hyperesthesia lateral foot edge on the right. no improvement by elevation. no tick bite recallable. in the laboratory confirmation of Lyme disease (high titer IgG, low titer IgM). no further manifestations except ACA.
Acrodermatitis chronica atrophicans. cigarette-paper-like wrinkles on the edematous swollen, flat erythematous right foot. a broad erythematous stripe ran along the tibia. the patient reported pain and instability while walking, but a neuroborelliosis was excluded.
Acrodermatitis chronica atrophicans. clearly visible, flabby skin atrophy and edematous redness on the right foot in a serologically proven infection with borrelia. the comparison to the left leg shows the clear difference. the patient spends several months in the black forest every summer.
Acrodermatitis chronica atrophicans: Initially flat, oedematous, livid red plaques; beginning transition to pronounced, flaccid atrophy with typical wrinkling of the skin (cigarette-paper phenomenon) and clearly translucent vein networks.
Acrodermatitis chronica atrophicans. Clearly visible, flaccid skin atrophy and edematous redness on the right foot in a serologically proven infection with Borrelia bacteria. The patient spends several months every summer in the Black Forest.
Acrodermatitis chronica atrophicans. 78-year-old female patient with confirmed neuroborreliosis 6 years ago and still positive Borrelia serology. Multiple, chronically inpatient, persisting for 2 years, asymmetrical (only on the left leg), blurred, sometimes burning pain, large, red to red-livid, smooth erythema, partly with crinkled surface (cigarette-paper-like puckering).
Acrodermatitis chronica atrophicans. general view: blurred, livid red, spots on the right thigh. skin in the lower area (arrow mark) folded like cigarette paper
Acrodermatitis chronica atrophicans. inflammatory oedematous stage: irregular acanthotic epithelium with orthokeratosis. oedema of the dermis with vasodilatation. perivascular, neurotropic and diffuse lymphohistiocytic infiltrate, reaching into the subcutis, rich in plasma cells.
Acrodermatitis chronica atrophicans. edema of the dermis; band-like compression of the diffuse inflammatory infiltrate subepithelial. no epitheliotropy. infiltrate from lymphocytes and plasma cells. clumped collagenous fibers.
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