Korean J Dermatol.  2000 Feb;38(2):155-162.

The Clinical Study of Zinc Deficiency Presented as a Skin Manifestation of Acrodermatitis Enteropathica

• Lim YS
• Lee MW
• Choi JH
• Sung KJ

Abstract

BACKGROUND: Zinc is an essential trace and has a close relation with skin metabolism and zinc deficiency is associated with acrodermatitis enteropathica, inflammatory bowel disease, chemotherapy, intravenous hyperalimentation, chronic diarrhea and other malabsoption state.
OBJECTIVE
The purpose of this study was to analyze the clinical characteristics of zinc deficiency presented as a skin manifestation of acrodermatitis enteropathica.
METHODS
In a retrospective study including 45 patients, we reviewed the clinical features of zinc deficiency presented as a skin manifestation of acrodermatitis enteropathica.
RESULTS
The ratio of male-to-female patients was 1.14:1 and the onset of the disease occured in childhood in 14 cases, and adulthood in 31 cases. The associated diseases were bowel diseases(13 cases), chemotherapy(11 cases), and postgastrectomy state(5 cases), only acrodermatitis enteropathica without associated disease(4 cases), and the other associated diseases were anorexia nervosa, malnutrition in old age, chronic pancreatitis and alcoholic liver disease, etc. The most common skin manifestation was erythematous scaly patches with erosion(77.8%) and vesicles, bullae, pustules and acneiform eruptions also developed. The perianal area was the most common anatomic site and the skin lesions were associated with diarrhea(35.6%), candida infection(20.0%), and severe hair loss(2.2%). In laboratory findings, low serum zinc levels were present in 26 patients among the 36 patients and a lower limit of the normal range of serum zinc was present in 8 patients among the 10 patients with normal zinc levels. Decreased serum albumin and protein level(48.9%), anemia (26.7%), and decreased alkaline phosphatase(6.7%) were observed.
CONCLUSION
We should pay special attention to the prevention of zinc deficiency in bowel disease, chemotherapy, chronic diarrhea and other malabsoption state. To prevent zinc deficiency, detailed skin examination was necessary and zinc should be added to maintenance therapy during chronic malnutrition and malabsorption state.

Keyword

Acrodermatitis enteropathica; Zine deficiency syndrome

MeSH Terms

Acneiform Eruptions
Acrodermatitis*
Anemia
Anorexia Nervosa
Candida
Diarrhea
Drug Therapy
Hair
Humans
Inflammatory Bowel Diseases
Liver Diseases, Alcoholic
Malnutrition
Metabolism
Pancreatitis, Chronic
Parenteral Nutrition, Total
Reference Values
Retrospective Studies
Serum Albumin
Skin Manifestations*
Skin*
Zinc*
Serum Albumin
Zinc