Case report reveals facial edema as a potential early sign of acrodermatitis chronica atrophicans in Lyme disease, suggesting timely diagnosis and treatment.
This case report describes a 63-year-old male presenting with facial and leg edema following a tick bite, in the absence of systemic symptoms. Despite a negative Borrelia DNA PCR, the patient was diagnosed with chronic atrophic acrodermatitis (ACA) based on clinical, serological (positive IgG for Borrelia burgdorferi), and histopathological findings (lymphoplasmacytic infiltrate). The patient showed a favorable response to doxycycline, with full resolution of symptoms within one month. ACA typically evolves from an inflammatory phase to atrophy and fibrosis. This case highlights that facial edema may represent an early manifestation of ACA, facilitating earlier diagnosis and intervention. Furthermore, PET/CT imaging may offer valuable insights into early ACA detection.
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Gabilondo et al. (2025) studied this question.
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