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November 1995

Identification of Borrelia afzelii in a Juxta-articular Fibroid Nodule From a Human Immunodeficiency Virus—Positive Patient With Acrodermatitis Chronica Atrophicans

Author Affiliations


Munich, Germany

St Gallen, Switzerland

Department of Dermatology Universitätsspital Gloriastrasse 31 CH-8091 Zürich, Switzerland


Arch Dermatol. 1995;131(11):1341-1342. doi:10.1001/archderm.1995.01690230123027

Acrodermatitis chronica atrophicans (ACA) is a clinical syndrome occurring in the late stage of infection with Borrelia burgdorferi. Acrodermatitis chronica atrophicans is a common presentation of late-stage Lyme disease in Europe but is rarely seen in patients in North America. Little is known about the course of Lyme disease in association with infection with the human immunodeficiency virus (HIV). With regard to the relatively high incidence of both diseases, the association of these entities is likely to become clinically important.

Report of a Case.  A 32-year-old man presented complaining of an indolent nodule near his elbow that had developed 6 months earlier. Four weeks before presentation, he had noticed a faint erythema on the back of his right hand. In the 10 days before presentation, he experienced pain in the ring finger on his right hand. Positive HIV serologic findings in this homosexual patient were first seen 4 years previously.

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