Weird Skin With Chronic Lyme Disease? You May Have ACA

What is ACA?

It is Acrodermatitis Chronica Atrophicans, a skin condition that frequently accompanies late stage Lyme borrelliosis (afzelii) but almost exclusively by those of European heritage.

Originally discovered and documented by Dr. Buchwald in 1883, it was not until 1902 when Dr’s Herxheimer and Hartmann began to study the phenomena in earnest that clear evidence began to mount. (The full name of the disease now carries the name of Dr. Herxheimer in most references.)

Now it is estimated that close to 10% of all Europeans with Lyme disease have ACA and in fact it is the most common late and chronic manifestation of European Lyme disease. However, given the fact that most doctors in North America do not believe in chronic Lyme disease, it is not surprising that dermotologists would not be trained to recognize ACA, and even Lyme literate doctors are sadly lacking any significant training about ACA.

Acrodermatitis chronica atrophicans is a skin condition that takes a progressive course that leads to atrophy of the skin in a variety of ways but sharing certain common characteristics.

Not surprisingly, involvement of the peripheral nervous system is frequently observed as a part of ACA (numbness, tingling, pain…)

As we know, clinical manifestations of Lyme borreliosis are almost unlimited. They can affect the skin, nervous system, muscles, joints eyes, ears, any organ including the heart. With ACA, the skin becomes papery thin and almost shiny and transparent so that the blood vessels, veins, arteries and tissue can be seen through the skin in various degrees which give the skin a pinkish/bluish color.

ACA is most commonly found on the hands and feet but can be found most anywhere on the body. Unfortunately, if you think you have it, there isn’t a very good chance of diagnosis.

Doctors absolutely despise patients who come into their office armed with information from the internet. However, you may have a chance if you come armed with the following article from WebMD: This site also has some remarkable pictures at

For your own understanding of ACA, a picture is worth a thousand words. There is a remarkable collection of pictures from (the lead picture for this post is from their site), make sure to click on your flag of nationality to read the text in the correct language:

Finally, there is a glaring and amazing point I would like to make – above and beyond the possible diagnosis that many may have been suffering with for years without a clue of its connection to chronic Lyme disease. Perhaps you will have jumped ahead to the obvious question this post raises by the accepted and even honored research by Dr. Hartmann and Dr. Herxheimer over one hundred years ago.

Why and how can it be that the respected doctors of the day believed without a doubt in chronic Lyme disease and studied symptoms and treatment of such while our “advanced doctors have disregarded over a century of research and documentation to cling to their platform of “there is no such thing as chronic Lyme disease.”

The next time you are challenged about chronic Lyme disease, you may want to bring up this ignored fact – that chronic Lyme disease is not debated in Europe. Do we even need to ask why?