Zinc deficiency due to alcoholic cirrhosis mimicking acrodermatitis enteropathica

Abstract

Zinc deficiency has been established as the cause of acrodermatitis enteropathica, an autosomal recessive disorder of zinc metabolism. The clinical features of acrodermatitis enteropathica may also be seen in acquired disorders of zinc deficiency. The authors describe a patient in whom the cause of zinc deficiency was alcoholic cirrhosis and malnutrition. The skin features of zinc deficiency were pronounced, the well-demarcated, erosive, erythematous eruption of the face, perineum, and extensor surfaces of the limbs and fingers being characteristic. Other cutaneous features of zinc deficiency that may occur include asteatotic eczema, alopecia, thin lustreless hair, nail dystrophy, and chronic paronychia. A single measurement of plasma or serum zinc concentration is not a good indicator of total body zinc stores. This patient's response to treatment, however, suggests that she indeed had acute zinc deficiency. This case appears to support the view that the best indicator of zinc deficiency is the response to treatment.