Aberer E, Stanek G, Ertl M, Neumann R
Acta Derm Venereol. 1987;67(3):225-31.
Acrodermatitis chronica atrophicans (ACA) and morphea are clinically distinct skin diseases with some common features and possible coexistence. We found antibodies to Borrelia burgdorferi in eight of fifteen patients with morphea. Six of them had IgG antibodies and two both IgG and IgM antibodies. Four of the eight seropositive and five of the seven seronegative patients had been treated with high dose penicillin previously. Spirochetal organisms could be cultured in Barbour-Stoenner-Kelly's medium from a skin biopsy of one seropositive untreated patient. Spirochetes were recovered from histological sections in three of eight, two seropositive and one seronegative morphea and in one of three erythema chronicum migrans patients by an avidin-biotin immunoperoxidase method. The similar clinical picture of ACA and morphea, the response to penicillin therapy in both entities, the presence of antispirochetal antibodies, the isolation of spirochetes in culture and the detection of spirochetal organisms on histological sections suggest a close relationship among these diseases. We conclude that morphea may represent a Borrelia infection. The correlation to ACA is discussed.
局限性慢性萎缩性肢端皮炎（ACA）和硬斑病是临床上不同的皮肤疾病，但有一些共同特征且可能并存。我们在15例硬斑病患者中的8例发现了抗伯氏疏螺旋体抗体。其中6例有IgG抗体，2例既有IgG抗体又有IgM抗体。8例血清学阳性患者中的4例以及7例血清学阴性患者中的5例先前曾接受过高剂量青霉素治疗。从1例未经治疗的血清学阳性患者的皮肤活检标本中，可在巴伯-斯托纳-凯利培养基中培养出螺旋体微生物。通过抗生物素蛋白-生物素免疫过氧化物酶方法，在8例硬斑病患者中的3例（2例血清学阳性和1例血清学阴性）以及3例慢性游走性红斑患者中的1例的组织切片中发现了螺旋体。ACA和硬斑病相似的临床表现、二者对青霉素治疗的反应、抗螺旋体抗体的存在、培养物中螺旋体的分离以及组织切片上螺旋体微生物的检测表明这些疾病之间存在密切关系。我们得出结论，硬斑病可能代表一种伯氏疏螺旋体感染。并对其与ACA的相关性进行了讨论。
