Ann Dermatol.  2011 Aug;23(3):352-356. 10.5021/ad.2011.23.3.352.

A Case of Atrophoderma of Pasini and Pierini Associated with Borrelia burgdorferi Infection Successfully Treated with Oral Doxycycline

Affiliations
  • 1Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Korea. choieh@yonsei.ac.kr

Abstract

Atrophoderma of Pasini and Pierini is a form of dermal atrophy that manifests as either single or multiple, sharply demarcated, hyperpigmented, non-indurated patches. These patches are marked by a slight depression of the skin, with an abrupt edge (i.e., the "cliff-drop" borders), usually located on the backs of adolescents or young adults. The pathophysiology of the disease is unknown, but some authors have suggested a role of Borrelia burgdorferi infection. A 35-year-old woman visited our department because of asymptomatic, hypopigmented, depressed patches on her chest and back lasting for three months. Laboratory evaluations were normal, except for positive serum antibodies to Borrelia burgdorferi. Histologic examination revealed a significantly decreased thickness of the dermis. The patient underwent treatment with oral doxycycline 200 mg/day for six weeks, after which the depth of depression was improved. Herein, we report a case of atrophoderma of Pasini and Pierini, associated with Borrelia burgdorferi infection, successfully treated with oral doxycycline.

Keyword

Atrophoderma pasini pierini; Borrelia burgdorferi; Doxycycline

MeSH Terms

Adolescent
Adult
Antibodies
Atrophy
Borrelia
Borrelia burgdorferi
Depression
Dermis
Doxycycline
Female
Humans
Skin
Thorax
Young Adult
Antibodies
Doxycycline

Figure

  • Fig. 1 Variably-sized round- to oval-shaped, hypopigmented patches on the intermammarial area and on the back, with preexisting psoriatic lesions. The lesions were depressed below the level of the surrounding skin and coalesced to form large depressed plaques.

  • Fig. 2 Histopathologic examination revealed a markedly thinned dermis, compared with that of the perilesional normal skin (a: lesion, b: perilesional normal skin) (H&E, ×12.5).

  • Fig. 3 After a three-week treatment with oral doxycycline 200 mg/day (b), the depths of the lesions were improved, compared with those of the pre-treatment state (a).


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