​Dermatology - Acrodermatitis Enteropathica

​Dermatology - Acrodermatitis Enteropathica 
An autosomal recessive zinc absorption condition called acrodermatitis enteropathica can strike babies who are breastfed or bottle-fed cow's milk shortly after they are weaned.

Acrodermatitis enteropathica causes growth failure, photophobia, and uncontrollable crying and whining in children. There is anemia, low zinc levels in the serum and plasma, and decreased zinc excretion in the urine.

Dry, scaly, strongly marginated, brilliantly red eczematous dermatitis patches and plaques eventually develop into vesiculobullous, pustular, erosive, and crusted lesions. Lesions first appear in the anogenital and perioral regions, then progress to the scalp, hands, feet, flexural regions, and trunk. Fingertips are shiny, erythematous, and show signs of secondary paronychia and fissures.
Wound healing is compromised when Candida albicans and S. aureus secondary infect lesions. In addition to paronychia, nail loss, and ridging of the nails, diffuse alopecia and graying of the hair also occur. There could be superficial erosions that resemble aphthous and a red, glossy tongue in the oral cavity.

The basis for the diagnosis is the combination of test and clinical data.
Zinc salt supplements taken orally or intravenously (IV) in two to three times the daily requirement can return zinc levels to normal in a matter of days to weeks. Severe erosive and infected skin lesions recover in 1-2 weeks after zinc replacement. Within 24 hours, the diarrhea stops and the irritation and mood sadness go better.