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January 1997

Long-term Prognosis in Patients Treated for Erythema Chronicum Migrans and Acrodermatitis Chronica Atrophicans

Author Affiliations

From the Departments of Dermatology (Drs Hulshof and Bouwes Bavinck) and Clinical Epidemiology (Dr Vandenbroucke), University Hospital, Leiden, the Netherlands; Department of Microbiology, Streeklaboratorium voor de Volksgezondheid, Arnhem, the Netherlands (Dr Nohlmans); Department of Bacteriology, Academical Medical Center, Amsterdam, the Netherlands (Dr Spanjaard); and Department of Rheumatology, Academical Hospital of Free University (Dr Dijkmans), Amsterdam.

Arch Dermatol. 1997;133(1):33-37. doi:10.1001/archderm.1997.03890370039007

Objective:  To determine whether Lyme borreliosis persisted or had recurred in patients treated for erythema chronicum migrans and acrodermatitis chronica atrophicans.

Design:  Retrospective follow-up study. Mean time between treatment and follow-up study was 8.8 years (SD, 66.6 years).

Setting:  Department of dermatology.

Patients:  Patients (N=52) treated from July 1964 to October 1992 for erythema chronicum migrans (ECM; n=44) or acrodermatitis chronica atrophicans (ACA; n=8). Fifty-two of the 56 successfully contacted and registered patients agreed to participate, for a response rate of 93%.

Main Outcome Measures:  Signs and symptoms of Lyme borreliosis; serum antibodies to Borrelia burgdorferi.

Results:  The interval from the time of diagnosis to study entry was 0.8 to 28.7 years (mean, 8.2 years). No symptoms or signs of active Lyme borreliosis were observed in the 52 patients. Antibodies to B burgdorferi were found in the ECM group in 1 of the 23 patients who received a recommended treatment and 2 of the 21 patients who received other treatments; antibodies were found in the ACA group in all 5 adequately treated patients who received a recommended treatment and in 1 of the 3 patients who received other treatments.

Conclusions:  There was no association between serologic results and type of treatment or between serologic results and complaints or symptoms at the time of the study in either of the patient groups. The prognosis in most patients with Lyme borreliosis is excellent.Arch Dermatol. 1997;133:33-37