Long-term prognosis in patients treated for erythema chronicum migrans and acrodermatitis chronica atrophicans
M. M. Hulshof, J. P. Vandenbroucke, L. M. Nohlmans, L. Spanjaard, J. N. Bavinck and B. A. Dijkmans
Department of Dermatology, University Hospital, Leiden, The Netherlands.
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.
