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Acquired acrodermatitis enteropathica - Skin
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Acquired acrodermatitis enteropathica - Skin

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Contributors: Neal D. Varughese MD, Jeffrey D. Bernhard MD, Noah Craft MD, PhD, Lindy P. Fox MD, Lowell A. Goldsmith MD, MPH, Michael D. Tharp MD
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Synopsis

Acquired acrodermatitis enteropathica represents an eczematous dermatitis that is associated with acquired zinc deficiency. The pathogenesis of the condition has not yet been elucidated. However, zinc plays a major role in skin health, namely in the proper maturation of basal keratinocytes. The disease occurs in patients with malabsorption (celiac sprue, gastric bypass), excessive diarrhea, low calorie intake (anorexia), and chronic disease (liver, renal disease). Medications can also alter zinc metabolism; diuretics and blood pressure medications increase urinary loss, which, along with any of the aforementioned predisposing factors, may precipitate disease.

Clinically, patients present with pruritic eczematous lesions distributed in perioral, acral, periorificial, and intertriginous areas (in a symmetrical pattern). Cases have been reported in young to elderly populations. In the very young, it is typically due to breast milk deficiency, whereas in elderly, the problem is essentially inadequate diet. Clinicians should also be aware of the possibility of zinc deficiency in patients receiving parenteral nutrition formulations.

Identical clinical findings may result from hereditary acrodermatitis enteropathica, a rare autosomal recessive disease caused by abnormal zinc absorption due to a transport deficiency across the small intestine.

Codes

ICD10CM:
E60 – Dietary zinc deficiency

SNOMEDCT:
12602008 – Acquired acrodermatitis enteropathica

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Last Updated: 04/19/2018
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Acquired acrodermatitis enteropathica : Diarrhea, Acral, Knee, Scaly plaque, Skin erosion, Toes
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