Acrodermatitis Enteropathica

Acrodermatitis Enteropathica (Zinc Deficiency Dermatitis)

Overview

Acrodermatitis enteropathica is a condition caused by severe zinc deficiency, either inherited (autosomal recessive mutation in the SLC39A4 zinc transporter gene) or acquired through dietary deficiency, malabsorption, or other causes. It presents with a classic triad of dermatitis (especially around body openings and on the extremities), diarrhea, and alopecia. Prompt zinc supplementation leads to rapid and dramatic improvement.

Key Symptoms

  • Erythematous, scaly, crusted, or vesiculobullous plaques around the mouth, eyes, nose, and perineum
  • Symmetric dermatitis on the hands, feet, knees, and elbows (acral distribution)
  • Diarrhea that may be chronic and watery
  • Hair loss (alopecia), including scalp, eyebrows, and eyelashes
  • Nail changes including ridging, dystrophy, or paronychia
  • Irritability, failure to thrive, and poor wound healing in infants and children

Affected Areas

Perioral (around the mouth), Periocular (around the eyes), Perineal and perianal, Hands and feet, Knees and elbows, Scalp

Care Instructions

  1. See a dermatologist or pediatrician promptly for evaluation and zinc level testing.
  2. Oral zinc supplementation (usually zinc sulfate or zinc gluconate) is the primary treatment.
  3. Inherited form requires lifelong zinc supplementation.
  4. Acquired form resolves with correction of the underlying cause and zinc repletion.
  5. Dramatic improvement in skin lesions is typically seen within days to weeks of starting zinc.
  6. Monitor zinc levels periodically to ensure adequate supplementation.

Medical Disclaimer: This information is for educational purposes only and does not replace professional medical advice. Always consult a qualified dermatologist for diagnosis and treatment.

Prevalence: Rare (inherited form); acquired zinc deficiency is more common in malnourished populations, premature infants, and patients on parenteral nutrition