: ACA and PCR/biopsies

[Guest guest]

:

ACA is mis diagnosed 82% of the time. Venous insuffieciency is the

disorder's name I couldn't think of.

ACA can test positive- almost as often as EN bullseye. as long as it's

before abx therapy.

In the case of my 2 biopsies- that couldn't go on to PCR because of the

way they were preserved - they did fit the description for histopatic

examination EXACTLY in that

QUOTE:

superficial and deep perivascular interstitial dermal infiltrate

consisting of Lympocytes, histiocytes and numerous plasma cells "

END QUOTE.

Thats word for word out of one of the papers, and my biopsy- and these

2 were before abx- so I had a 50/50 chance - bust it was

dashed because of the way they were preserved.

I'm sure what I had on my for arms was/is ACA - it's pretty distinctive-

except no one knows how to recognize it 82% of the time.

Dummies.

Barb

Here are the references.

J Am Acad Dermatol. 2005 Jun;52(6):1091-4.

Acrodermatitis chronica atrophicans in a 15-year-old girl misdiagnosed

as venous insufficiency for 6 years.

Zalaudek I, Leinweber B, Kerl H, Mullegger RR.

Department of Dermatology, Medical University of Graz, Graz, Austria.

Acrodermatitis chronica atrophicans, the characteristic cutaneous

manifestation of late Lyme borreliosis, typically occurs in elderly

women. To our knowledge, only 4 cases of acrodermatitis chronica

atrophicans in children have been described. Prompt diagnosis and

treatment are important to prevent progression of disease and

extracutaneous complications. We describe a 15-year-old girl with

acrodermatitis chronica atrophicans of the left leg that had been

misdiagnosed as chronic venous insufficiency for 6 years. Because of

the long-standing disease course, skin changes expanded and progressed

to marked atrophy. The correct diagnosis was finally based on clinical,

histopathologic, and serologic findings. The girl was treated with oral

doxycycline for 6 weeks, but her skin changes did not fully normalize.

This case illustrates the possibility of acrodermatitis chronica

atrophicans appearing in childhood and the difficulties in

differentiating vascular disorders from acrodermatitis chronica

atrophicans on the basis of the clinical appearance alone.

PMID: 15928636 [PubMed - in process]

Eur J Clin Microbiol Infect Dis. 1995 Jan;14(1):1-

Polymerase chain reaction for detection of Borrelia burgdorferi DNA in

skin lesions of early and late Lyme borreliosis.

von Stedingk LV, Olsson I, Hanson HS, Asbrink E, Hovmark A.

Department of Clinical Microbiology, Karolinska Hospital, Stockholm,

Sweden.

The aim of this study was to evaluate the polymerase chain reaction

(PCR) as a diagnostic tool for Lyme borreliosis on large numbers of

samples from clinically well-defined cases of early and late cutaneous

borreliosis. Skin biopsy specimens from patients with erythema migrans

and acrodermatitis chronica atrophicans were analysed blindly together

with an equal number of control biopsies. Using two different dilutions

of each DNA specimen increased the number of total positives detected.

All of the 76 control biopsies were PCR negative. Biopsy specimens from

18 of 26 (69%) erythema migrans lesions and from 22 of 36 (61%)

acrodermatitis chronica atrophicans lesions were PCR positive. Fourteen

post-therapy biopsies from patients with acrodermatitis chronica

atrophicans were all negative, supporting the opinion that antibiotic

therapy is successful in this chronic manifestation of Lyme borreliosis.

PMID: 7729446 [PubMed - indexed for MEDLINE]