Research Article: A Case of Acrodermatitis Enteropathica

Acrodermatitis enteropathica (AE) is a rare, bullous disorder that has a significant impact on the child’s quality of life and is fatal if untreated. AE is characterised by a triad of periorificial and acral dermatitis, diarrhoea and alopecia.

Adequate zinc consumption is found to be a better option to treat AE.

Case report:

• A case of 15 month old female infant presented with a progressive rash and golden yellow crusting around her face, groin and buttocks.
• The baby had breast fed and was up to date with her immunisations, not taking any medication.
• A diagnosis of Impetigo was made and the child received antibiotic therapy for three weeks with no clinical improvement.

Clinical Features:

• Tense, clear variable sized bulla and pustules with a well-demarcated, erythematous base, distributed around her mouth.
• Perineum and the acral sites of hands and feet.
• clumps of hair loss from the frontal areas of her scalp.

Investigations:

• After a multi-disciplinary team discussion of the case, cultures of the wounds were taken which showed mixed skin bacteria and isolated Candida albicans.
• Her serum zinc level was tested and discovered to be <2.0 μmol/L (11.4μmol/L-24.8 μmol/L). Subsequently a diagnosis of Acrodermatitis Enteropathica was made.

Therapeutic Intervention:

• After administration of zinc sulphate 1 mg/kg/day orally for one week, the cutaneous lesions showed improvement and her serum zinc level increased to 9.4 μmol/L.
• Subsequently oral zinc sulphate 2.5 mg/kg/day, mometasone ointment and mupirocin 2% ointment were prescribed.
• All lesions were disappeared.

Benefits of zinc in diet:

• Zinc is an essential element of our diet. It is a constituent of the enzymes that assist with brain function, cytokine and antioxidant production and carbohydrate metabolism.
• Zinc is found in meat, shellfish, spinach, nuts and wheat germ.