To cite: Nguyen AL, de Kort WJA, Theunissen CCW. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/ bcr-2016-216033 DESCRIPTION Background Acrodermatitis chronica atrophicans (ACA) is the first presentation of Lyme borreliosis in about 3% of patients. This case is important as it reminds physicians that ACA should be considered in the differential diagnosis of non-acute...

As food allergies become increasingly prevalent and testing methods to identify “food allergy” increase in number, the importance of careful diagnosis has become even more critical. Misdiagnosis of food allergy and inappropriate use of unproven testing modalities may lead to a harmful food-elimination diet. This case is an example of an infant who was placed on an overly restrictive elimination...

Acrodermatitis chronica atrophicans is a rare late manifestation of tick-borne Borrelia burgdorferi infection, manifesting as inflammatory and atrophic lesions on acral skin. We describe the case of a 73-year-old woman with skin changes progressed to marked atrophy on her left hand and an edematous inflammatory involvement of the face. The diagnosis of acrodermatitis chronica atrophicans was ma...

Atopic is the most common of the dermatitides seen in infancy and childhood, but there are numerous other diseases that can mimic the skin findings. These include seborrheic dermatitis, immunodeficiency, and psoriasis in infancy; scabies, tinea corporis infection, perioral, nummular, contact, and molluscum dermatitis in childhood. It is sometimes extremely difficult to differentiate between ich...

A 2-month-old preterm boy who developed symptomatic zinc deficiency while being exclusively breast fed is described. Oral zinc supplements induced a complete remission but mucosal 65Zn uptake studies and metabolic balances conducted before and after withdrawal of the supplements excluded the diagnosis of acrodermatitis enteropathica. By age 12 months the boy was well and no longer required zinc...

Acrodermatitis enteropathica is classified as a congenital autosomal recessive type and an acquired transient type. This disease manifests as acral and periorificial dermatitis, alopecia, intractable diarrhea, and failure to thrive. Whereas the autosomal hereditary type is caused by malabsorption of zinc in the intestine, the acquired type is caused by low nutritional support or decreased perip...

3 Land Use Planning 10 3.1 The Problem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 3.2 The AEZ Land Use Allocation Model . . . . . . . . . . . . . . . . . . . . . 12 3.2.1 A Summary of the AEZ Methodology . . . . . . . . . . . . . . . . . 12 3.2.2 The core model constraint set . . . . . . . . . . . . . . . . . . . . . 13 3.2.3 Decision variables . . . . . . . . . . . ...