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Acquired acrodermatitis enteropathica due to zinc‐depleted parenteral nutrition
Author(s) -
Wiznia Lauren E.,
Bhansali Suneet,
Brinster Nooshin,
AlQaqaa Yasir M.,
Orlow Seth J.,
Oza Vikash
Publication year - 2019
Publication title -
pediatric dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.542
H-Index - 73
eISSN - 1525-1470
pISSN - 0736-8046
DOI - 10.1111/pde.13865
Subject(s) - acrodermatitis enteropathica , zinc deficiency (plant disorder) , medicine , parenteral nutrition , zinc , acrodermatitis , enteral administration , intensive care medicine , micronutrient , dermatology , gastroenterology , pathology , materials science , metallurgy , alternative medicine
Well‐known causes of zinc deficiency, also referred to as acrodermatitis enteropathica ( AE ), include defects in intestinal zinc transporters and inadequate intake, but a rare cause of acquired zinc deficiency discussed here is an iatrogenic nutritional deficiency caused by parenteral nutrition administered without trace elements. While zinc‐depleted parenteral nutrition causing dermatosis of acquired zinc deficiency was first reported in the 1990s, it is now again relevant due to a national vitamin and trace element shortage. A high index of suspicion may be necessary to diagnose zinc deficiency, particularly because early clinical findings are nonspecific. We present this case of acquired zinc deficiency in a patient admitted to a pediatric intensive care unit for respiratory distress and atypical pneumonia, who subsequently developed a severe bullous eruption due to iatrogenic zinc deficiency but was treated effectively with enteral and parenteral zinc supplementation, allowing for rapid re‐epithelialization of previously denuded skin.