Abstract

Acrodermatitis Chronica Atrophicans Herxheimer (ACA) is a tick-born disease due to infection by Borrelia afzelii, the major vector organism is Ixodes rhicinus. We report on a 48-year-old male patient who developed extensive livid-erythematous fibrosclerotic symmetric plaques associated with hyperpigmented widely distributed lesions within the tension lines, and acrocyanosis. The diagnosis of ACA has been confirmed by histopathologic examination of a skin biopsy and laboratory investigations with positive IgG and IgM immunoblots. The patient was treated by intravenous ceftriaxone resulting in partial remission of cutaneous and extracutaneous symptoms.

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