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Acrodermatitis atrophicans Herxheimer is a skin disease that can occur in the late stage (stage III) of Lyme disease.

It leads to a reddish-blue discolouration of the skin, especially in the lower extremities of older patients, resulting in subsequent tissue loss. The skin becomes paper-thin and shiny, and apparent “chronic acrodermatitis” can develop.

In the early stages of the disease’s progression, an asymptomatic swelling and livid discolouration of the affected skin area appears. As the disease progresses, the subcutaneous tissue loses substance (atrophy). The skin appears thin (like a cigarette paper), shows a livid patchy or extensive discolouration and veins can become particularly visibly. 

Diagnosis of acrodermatitis

The doctor will make a clinical diagnosis to determine whether a patient has acrodermatitis; in addition, some laboratory tests will also be carried out. A skin biopsy is also possible, in addition to the standard diagnosis of Lyme disease.

Treatment of acrodermatitis

Antibiotics are used to treat acrodermatitis. The duration of the therapy depends on the stage of the disease. The dosage must be sufficiently high and long enough to completely kill all bacteria.