 Physicians should use serologic and histologic examination to confirm the diagnosis of ACA.Treatment consists of antibiotics including doxycycline and penicillin for up to four weeks in the acute case.The first record of ACA was made in 1883 in Breslau, Germany, where a physician named Alfred Buchwald first delineated it.Herxheimer and Hartmann described it in 1902 as a "tissue paper like" cutaneous atrophy.