Case for Diagnosis (Acrodermatitis Enteropathica?). Presented by Dr. George W. Hambrick, Jr. and (by invitation) Dr. Victor Formisano.
The patient is a 15-year-old dwarf weighing 48 lb. He has limited neck and hand motion and a shuffling gait due to dermatitis. He has erythematous, scaling, thick plaques on his face, cubital fossae, hands, feet, and inguinal areas; he has keratoderma of palms and soles, and diminished hair growth in axillae, pubic area, and scalp. There are large areas of follicular keratosis. He also has bilateral corneal opacities, carious teeth, and flexion contractures of hands.From early infancy the patient was a feeding problem and was able to tolerate only goat's milk during his first 6 months. Since age 3 months an erythematous scaling eruption has been present on his scalp, face, neck, arms, and inguinal regions. He has never been free of cutaneous lesions, but at times only his hands