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作者报告了美国莱姆(Lyme)病地方性流行区的2例病人,皆以萎缩性慢性肢端皮炎(ACA)作为伯氏包柔氏螺旋体感染的主要表现.例1.女,24岁.双足背、左上臂内侧慢性皮损4年.双手和双膝出现晨僵持续近1小时,伴双侧髋关节痛和双上肢弥散性感觉异常.最近有指(趾)苍白和紫绀发作.否认蜱叮咬史.体检:双足背见萎缩性色素沉着性皮损,左上臂内侧有两片色素沉着性皮损,直径约3～5cm,环状中心苍白.莱姆病
The authors report 2 patients with endemic endemic Lyme disease in the United States, all characterized by atrophic chronic acral dermatitis (ACA) as a predominant infection with Borrelia burgdorferi. Example 1. Female, 24 years old. Dorsiflexion, chronic medial left upper arm lesions for 4 years morning and morning stiffness in both hands and knees for nearly 1 hour, with bilateral hip pain and upper extremity diffuse sensory abnormalities, recently there are finger (toe) pale and cyanotic episodes. Denied the history of tick bites Physical examination: atrophy of the dorsoventral pigmented lesions, medial left upper arm with two pigmented lesions, a diameter of about 3 ~ 5cm, pale annular center Lyme disease