Acrodermatitis chronica atrophicans in children: Report on two cases and review of the literature.

Maraspin V, et al. Ticks Tick Borne Dis. 2019.


Acrodermatitis chronica atrophicans is a late manifestation of European Lyme borreliosis and is characterized by high levels of borrelial IgG antibodies, slowly expanding skin redness usually beginning on distal parts of extremities, and corresponding histologic findings. It very rarely develops in children. The main prerequisite for the diagnosis is clinical suspicion. In the present article we report on two children with acrodermatitis chronica atrophicans and on the findings of a PubMed literature search on acrodermatitis chronica atrophicans in childhood, published in the past three decades.



Acrodermatitis chronica atrophicans (ACA) is a fancy way of saying long-term persistence of Borrelia infection in the skin.  

Not a lot is known about this condition but what is known is that lack of adequate or appropriate treatment of early Lyme leads to the condition.  Borrelia’s ability to change antigens thereby messing up the immune response doesn’t help matters either.

As to the “3 stages of Lyme,” folks can jump from stage to stage with no particular rhyme or reason:

One little girl within 4-6 hours after tick bite couldn’t walk or talk:

Please see for a slide-show of pictures.  Swelling and a bluish red coloring of the skin are fairly classic symptoms along with numbness, burning, tingling, muscle weakness, and Babinski sign (a reflex movement of the big toe upward instead of downward when the plantar aspect of the foot is stroked, a manoeuvre used to test injury to, or diseases of, the upper motor neurons).

The Medscape article also points out that other genospecies of borrelia have been known to cause ACA. They also point out ACA is often under diagnosed.

Please read this before taking the author’s advice about treatment length:  Then don’t forget the possible involvement of coinfections:  For the first time, Garg et al. show a 85% probability for multiple infections including not only tick-borne pathogens but also opportunistic microbes such as EBV and other viruses.

I’m glad articles like these are coming out.  In order for researchers and mainstream medicine to believe something it has to be published.  But just because something hasn’t been published doesn’t mean it doesn’t exist.