Illustrative example of a patient with acrodermatitis chronica atrophicans. 


Acrodermatitis chronica atrophicans is a late skin manifestation of Lyme disease that develops insidiously several years after initial infection (range, 0.5–8 years). 
Approximately 20% of patients have a history of a preceding erythema migrans lesion, usually of the same extremity [242]. Acrodermatitis chronica atrophicans is diagnosed most frequently in women >40 years of age. Although any of the species of Lyme Borrelia may cause the lesion, by far the most common etiologic agent is B. afzelii. 

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