Acrodermatitis chronica atrophicans physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Anahita Deylamsalehi, M.D.[2]

Skin examination of acrodermatitis chronica atrophicans‘s patients include blue, red or brown discoloration, hypopigmentation, indurated plaques and wrinkles, thinning and shining of involved skin. Readily visible veins, edema, ulcers and peeling are usually found. Although the most common location of these skin changes are observed on limbs, there are some cases with facial and abdominal involvement. Peripheral neuropathy develops in 50% of patients. Physical examination of some patients may reveal ulnar bands. Moreover fibrotic nodules could be seen on bony prominences, such as tibia or ulna.

Physical examination of patients with acrodermatitis chronica atrophicans is usually remarkable for skin changes such as blue-red discoloration, thinning, shinning and atrophy.

Vital signs of patients with acrodermatitis chronica atrophicans is usually normal.

• The following are some of the findings in skin examination of acrodermatitis chronica atrophicans‘s patients:^{[1][2][3][4][5]}
  • Blue, red or brown discoloration
  • Darkening of skin
  • Hypopigmentation
  • Indurated plaques
  • Thinning
  • Shining (also addressed as “cigarette paper skin”)
  • Visible veins
  • Wrinkles
  • Swelling
  • Peeling
  • Fibrotic nodules (commonly on bony prominences, such as ulnar or tibial areas)
  • Fibrosis
  • Ulcers
• In rare cases abdomen‘s skin is involved.

• Facial involvement is rare but may occurr.^[1]

• Neck examination of patients with acrodermatitis chronica atrophicans is usually normal.

• Pulmonary examination of patients with acrodermatitis chronica atrophicans is usually normal.

• Cardiovascular examination of patients with acrodermatitis chronica atrophicans is usually normal.

• Abdominal examination of patients with acrodermatitis chronica atrophicans is usually normal.

• Back examination of patients with acrodermatitis chronica atrophicans is usually normal.

• Genitourinary examination of patients with acrodermatitis chronica atrophicans is usually normal.

• Peripheral neuropathy develops in 50% of patients.^[7]
• The most commonly observed form of peripheral neuropathy is sensory polyaneuropathy.^[7][8]

• Extremities of patients with acrodermatitis chronica atrophicans are the most common area of skin involvement.^[4]
• Moreover patients with acrodermatitis chronica atrophicans can develop joint deformity.^[1]
• Physical examination of some patients may reveal ulnar bands.
• Fibrotic nodules could be seen on bony prominences, such as tibia or ulna.^[4]
• In rare cases tenosynovitis and dactylitis have been reported.^[9][7]

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