Zusammenfassung
Wir berichten von einer 12-jährigen Patientin, die sich mit scharf begrenzten großflächigen
Hyperpigmentierungen an Stamm und Extremitäten sowie einer Borrelia burgdorferi-Infektion
mit Gelenkbeschwerden vorstellte. Die histologische Untersuchung einer Hautveränderung
war mit einer Atrophodermia Pasini et Pierini (APP) vereinbar. Therapeutisch wurden
initial Doxycyclin, später intravenös Methylprednisolon und Methotrexat verabreicht.
Differenzialdiagnostisch kam neben einer oberflächlichen Morphaea und Lyme-Arthritis
eine progressive systemische Sklerodermie infrage.
Abstract
Atrophodermia of Pasini and Pierini is a form of dermal atrophy that manifests as
either single or multiple, sharply demarcated, hyperpigmented, non-indurated patches.
We report on a 12-year-old girl who came to us with multiple hyperpigmented patches
which had been growing on trunk and limbs as well as fatigue and atraumatic joint
pain. Laboratory was normal, except for positive serum antibodies to Borrelia burgdorferi. The histological findings of the biopsy showed a normal epidermis, slight atrophy
with flattened rete ridges, dermal edema and a mild perivascular lymphohistiocytic
infiltrate with plasma cells suggesting atrophodermia Pasini Pierini. Doxycycline
was initiated and followed by intravenously applicated methylprednisolone as well
as methotrexate. Apart from Morphaea Lyme Arthritis, idiopathic atrophodermia of Pasini
and Pierini and progressive systemic scleroderma as a possible cause should be considered.
