Case report
Acrodermatitis enteropathica–like eruption and failure to thrive as presenting signs of cystic fibrosis

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We describe a female infant with an acrodermatitis enteropathica–like eruption as the presenting sign of rapidly fatal cystic fibrosis. The patient had growth retardation, developed an erythematous eruption unresponsive to oral zinc, and finally a generalized erosive dermatitis with associated edema, anemia and hypoproteinemia.

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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

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    • Metabolic and storage diseases

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    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.

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