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Course: Acrodermatitis Enteropathica

CME Credits: 1.00

Released: 2023-11-08

A woman in her 20s presented for evaluation of painful, red skin lesions that had first presented 6 months prior and involved the face, groin, and extremities. It was insidious in onset, initially appearing over the groin and gradually progressing to involve other sites. A previous episode of similar lesions occurred at 1 year of age during weaning from breast milk, which improved with zinc supplementation. She denied food faddism, gastrointestinal complaints, or prior drug intake. A family history of similar skin lesions was absent. On examination, there were sharply demarcated erythematous erosive plaques with crusting seen over the periorificial areas of the face and groin along with involvement of the dorsum of the hands and feet (). There was diffuse nonscarring alopecia involving the scalp and eyebrows. Serum zinc levels were found to be low (23 µg/dL; normal range: 50-150 µg/dL; to convert to µmol/L, multiply by 0.153) along with a low serum alkaline phosphatase level (31 U/L; normal range: 44-147 U/L; to convert to µkat/L, multiply by 0.0167). Histopathology revealed psoriasiform epidermal hyperplasia with confluent parakeratosis and epidermal pallor consistent with acrodermatitis enteropathica (AE). Oral zinc supplementation was initiated at a dose of 3 mg/kg, with rapid improvement.


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