Joint Manifestations

  • P. Herzer

Abstract

Though joint symptoms had been previously mentioned in case reports of patients in Europe with erythema chronicum migrans (Stadelmann 1934; Weber 1974) or lymphocytic meningitis (Bannwarth 1941; Schaltenbrand 1949; Erbslöh und Kohlmeyer 1968), the association of arthritis with erythema migrans and neurological disease was not recognized until Lyme arthritis was described in North America (Steere et al. 1976, 1977a, b). However, joint abnormalities in patients with acrodermatitis chronica atrophicans (ACA) had been repeatedly described in the European dermatological literature since 1922 (Jessner 1922; Jessner and Loewenstamm 1924; Hövelborn 1931; Benjamowitsch and Maschkilleisson 1933; Gans 1933; Gans and Landes 1952; Hopf and Klingmüller 1966; Müller 1969) and also in a case report from North America (Sweitzer and Laymon 1935); this even led to the term “Akrodermatitis atrophicans arthropathica” being proposed (Gans and Landes 1952). However, a causal relation of joint and bone abnormalities with ACA had been called in question (Hauser 1955). In the earlier rheumatological literature, there is only one short reference to five cases of ACA with polyarticular involvement of joints beneath affected skin (Schilling 1970). Nowadays, in view of the clinical spectrum of Lyme borreliosis, the association of ACA and Lyme arthritis is obvious. Furthermore, recent reports (Asbrink et al. 1986; Hovmark et al. 1986) have confirmed the earlier presumptions of specific joint and bone abnormalities under the affected skin in ACA.

Keywords

Fatigue Arthritis Europe Osteoporosis Meningitis 

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  • P. Herzer

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