The authors describe a patient with repeated and untreated erythema migrans in her personal history and clinically developed acrodermatitis chronica atrophicans (ACA) with fibrous nodules over several joints on her right hand. The erythema and fibrous nodules responded to treatment with penicillin G, the signs of atrophy lingering on. In the discussion there is covered in great detail the history of ACA, dermal alterations in the third stage of Lyme borreliosis, as well as the importance of histopathological examination.

        Key words: Lyme borreliosis - acrodermatitis atrophicans - fibrous nodules