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June 1992

Acrodermatitis Chronica Atrophicans

Author Affiliations

University of Arizona College of Medicine Tucson, AZ 85719; 2375 N Wyatt Suite 109 Tucson, AZ 85712; The University of New Mexico School of Medicine Department of Dermatology 2701 Frontier NE Room 268 Surge Building Albuquerque, NM 87131

Arch Dermatol. 1992;128(6):858-860. doi:10.1001/archderm.1992.01680160148032

To the Editor.—  We report a possible case of acrodermatitis chronica atrophicans (ACA), a spirochetal disease almost entirely limited to Europe.

Report of a Case.—  A 68-year-old native of New York, NY, reported a 20-year history of thinning of the skin with easy bruising and fragility. Eight years after the onset of skin changes, hepatosplenomegaly, thrombocytosis, an increased serum IgM level, and an uncharacterized dysproteinemia were discovered, all of unknown cause and asymptomatic. These problems all were without long-term follow-up. He had also noted the recent onset of mild hearing loss. He had traveled only to Great Britain 15 years before the onset of symptoms.Findings from his physical examination revealed diffuse thinning of the scalp and body hair and generalized thinning of the skin, especially prominent over the extensor surfaces of the limbs and joints that was characterized by a "cigarette paper" appearance (Fig 1). Intertriginous skin was violaceous

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