Correspondence |

Think Zinc Deficiency: Acquired Acrodermatitis Enteropathica Due to Poor Diet and Common Medications

James B. Macdonald, MD; Suzanne M. Connolly, MD; David J. DiCaudo, MD
Arch Dermatol. 2012;148(8):961-963. doi:10.1001/archdermatol.2012.435.
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Acrodermatitis enteropathica is a periorificial and intertriginous papulosquamous eruption typically seen in infants with hereditary intestinal zinc-transporter defects.1 However, acquired acrodermatitis enteropathica (AAE) can occur when serum zinc levels are depressed. Herein, we report 4 cases of AAE in elderly patients. Patients presented with refractory periorificial and intertriginous eruptions that were attributable to acquired zinc deficiency from poor diet and use of common medications.

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Figure 1. Sharply marginated, confluent erythematous patches affecting the medial thighs (A) and the crural folds (B) of an 89-year-old man with zinc deficiency due to diet.

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Figure 2. Pruritic, bright red, confluent patches on the groin of a 67-year-old man with zinc deficiency who was taking an angiotensin receptor blocker.

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Figure 3. Parakeratosis, hypogranulosis, upper epidermal pallor, and keratinocyte dysmaturation (hematoxylin-eosin, original magnification ×400).




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