Acrodermatitis enteropathica (Children)
๐ฟ Acrodermatitis enteropathica is a rare inherited disorder caused by zinc malabsorption. It presents with chronic diarrhoea, a characteristic inflammatory rash around the mouth/anus, and alopecia.
๐ About
- Autosomal recessive condition due to impaired intestinal zinc absorption
- Defect in zinc transporter protein (ZIP4)
โ๏ธ Aetiology
- Mutations in SLC39A4 gene โ defective ZIP4 transporter
- Human breast milk zinc is more bioavailable than cowโs milk or formula
- Symptoms often appear after weaning from breast milk
๐ฉบ Clinical Features
- Psoriasis-like dermatitis around eyes, nose, mouth, buttocks, and perineum
- Acral involvement (hands/feet)
- Alopecia and nail changes
- Recurrent infections due to immunocompromise
- Presentation: bottle-fed infants within days/weeks of birth; breast-fed infants soon after weaning
๐ Investigations
- FBC โ anaemia
- Low serum/plasma zinc levels (normal: 10.7โ23.0 ฮผmol/L)
- Reduced urinary zinc excretion
- Skin biopsy may show characteristic features
๐ Management
- Oral zinc sulfate 30โ150 mg/day โ rapid remission within days
- Treat secondary bacterial/fungal infections appropriately
๐ References