Journal of the American Academy of Dermatology
Case reportAcrodermatitis enteropathica–like eruption and failure to thrive as presenting signs of cystic fibrosis
Section snippets
Case report
The patient was a term female infant with unremarkable maternal, antenatal, and initial postnatal periods and normal growth. Minor episodes of otitis media, thrush, and reactive airway disease were noted in the initial postnatal period. The patient developed growth retardation at 4 months of age. At 5 to 6 months of age, she developed an erythematous eruption with overlying desquamation in acral and perioral distributions. At that time, the patient was evaluated for zinc deficiency with a
Discussion
It is important to recognize that an acrodermatitis enteropathica–like eruption can be a cutaneous manifestation of CF. This is especially true in patients with concomitant failure to thrive, hypoproteinemia, anemia, and edema as this portends high morbidity and mortality.7 Our patient had decreased levels of total protein, albumin, and zinc, but skin involvement did not resolve after initial zinc supplementation. This finding would lend support to the idea that the protein-energy-malnutrition
References (32)
- et al.
Acrodermatitis enteropathica
Clin Dermatol
(2000) - et al.
Cystic fibrosis
Lancet
(2003) Assessment of marginal zinc status in humans
J Nutr
(2000)- et al.
Acrodermatitis enteropathica-like cutaneous lesions in organic aciduria
J Pediatr
(1994) - et al.
Glucagonoma syndrome
J Am Acad Dermatol
(1988) - et al.
Neonatal citrullinemia associated with cutaneous manifestations and arginine deficiency
J Am Acad Dermatol
(1986) - et al.
Interactions between zinc, essential fatty acids and prostaglandins: relevance to acrodermatitis enteropathica, total parenteral nutrition, the glucagonoma syndrome, diabetes, anorexia nervosa, and sickle cell anemia
Med Hypotheses
(1980) - et al.
A case of acrodermatitis enteropathica-like dermatosis caused by ornithine transcarbamylase deficiency
J Am Acad Dermatol
(2002) - et al.
Zinc deficiency manifested by dermatitis and visual dysfunction in a patient with Crohn's disease
J Gastroenterol
(1998) - et al.
Cystic fibrosis manifesting with acrodermatitis enteropathica-like eruption. Association with essential fatty acids and zinc deficiencies
Arch Dermatol
(1983)
Acrodermatitis enteropathica-like eruption as the presenting sign of cystic fibrosis- case report and review of the literature
Eur J Pediatr
Acrodermatitis enteropathica-like eruption: a sign of malabsorption in cystic fibrosis
Pediatr Dermatol
Persistent morbidity and mortality of protein caloric malnutrition in young infants with cystic fibrosis
J Pediatr Gastroenterol Nutr
Dermatitis as a presenting sign of cystic fibrosis
Arch Dermatol
Absorption of trace elements: zinc
Int J Vitam Nutr Res Suppl
Acrodermatitis acidemia secondary to malnutrition in glutaric aciduria type I
Eur J Dermatol
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2008, Journal of the American Academy of DermatologyMalabsorption-related rash in cystic fibrosis does not portend a poor prognosis
2008, Journal of the American Academy of DermatologyUpdate on the management of vitamins and minerals in cystic fibrosis
2022, Nutrition in Clinical PracticeAtypical presentation of cystic fibrosis in an infant
2022, Indian Journal of Dermatology
Funding sources: None.
Conflicts of interest: None declared.
This case was presented at the annual conference of the Society for Pediatric Pathology, Little Rock, Arkansas, October 29, 2004.
Reprints not available from the authors.