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Correlation of Reflectance Confocal Microscopy and Dermatopathology Findings in a Case of Acrodermatitis Chronica Atrophicans

Gülseren, Duygu, MD*,†; Cerroni, Lorenzo, MD; Hofmann-Wellenhof, Rainer, MD; Arzberger, Edith, MD

The American Journal of Dermatopathology: May 2018 - Volume 40 - Issue 5 - p 367–370
doi: 10.1097/DAD.0000000000001069
Extraordinary Case Report

Abstract: Acrodermatitis chronica atrophicans (ACA) that is characterized by thin, papery dry, translucent, and alopecic patches with visible superficial veins is a late cutaneous manifestation of Lyme borreliosis. Clinical findings, a history of exposure to tick bite, and serology are helpful for the diagnosis of ACA and sometimes a biopsy is performed to rule out other infectious or inflammatory processes. In this study, we report reflectance confocal microscopy (RCM) findings in a case of ACA. RCM examination revealed a flattened surface with broadened skin folds, a flattened dermoepidermal junction with few papillae and less bright basal cells and multiple small bright reflecting spots in the dermis. To the best of our knowledge, this is the first description of the RCM findings in this disorder.

*Department of Dermatology, Hacettepe University, School of Medicine, Ankara, Turkey; and

Department of Dermatology, Medical University of Graz, Graz, Austria.

Correspondence: Duygu Gülseren, MD, Department of Dermatology and Venereology, Ankara Polatli State Hospital, Ankara Eskisehir yolu üzeri, 06900, Polatli/Ankara, Turkey (e-mail:

The authors declare no conflicts of interest.

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