Acrodermatitis Enteropathica.

JAMA Dermatol

Department of Dermatology, JIPMER, Puducherry, India.

Published: January 2024

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http://dx.doi.org/10.1001/jamadermatol.2023.4147DOI Listing

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Objectives: Acrodermatitis dysmetabolica (AD) is a dermatologic manifestation associated with inherited metabolic disorders (IMDs), distinct from acrodermatitis enteropathica, which occurs solely due to zinc deficiency.

Case Presentation: This report presents two pediatric cases: a 30-month-old girl with maple syrup urine disease (MSUD) experiencing AD secondary to severe isoleucine deficiency due to a protein-restricted diet, showing improvement with dietary adjustments, and a 2.5-month-old boy infant with propionic acidemia (PA) who developed AD alongside septic shock, which progressed despite intervention.

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ZIP4, a pivotal member of the ZIP family, is the causative gene for the hereditary disorder AE (acrodermatitis enteropathica) in humans, and plays an essential role in regulating zinc ion balance within cells. While research on the molecular structure of ZIP4 continues, there remains a lack of full understanding regarding the stereo-structural conformation of ZIP4 molecules. Currently, there are two hypotheses concerning the transport of zinc ions into the cytoplasm by ZIP4, with some contradictions between experimental studies.

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Zinc Supplementation for Acrodermatitis Enteropathica Overlapped with Psoriasiform Lesions.

Psoriasis (Auckl)

November 2024

Department of Dermatology, Naval Medical Centre, Naval Medical University, Shanghai, 200052, People's Republic of China.

Acrodermatitis enteropathica (AE) can be caused by inherited or acquired zinc deficiency, among which site-specific skin lesions or even psoriasiform skin manifestations are present. Few cases exist in the literature involving the diagnosis and treatment of AE overlapped with psoriasiform lesions. In this case, we reported a teenage boy presented characteristic site-specific skin lesions of AE with low serum zinc level, subsequently progressed into generalized pustular psoriasiform manifestations under a genetic background, while a rapid recovery was observed after monotherapy of zinc supplementation.

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Article Synopsis
  • A two-year-old girl experienced misdiagnoses such as tinea corporis and psoriasis, leading to ineffective treatments until a proper evaluation revealed her low zinc levels.
  • After being diagnosed with AE, she was treated with zinc sulfate, resulting in the complete resolution of her skin lesions within two weeks.
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