Rana Jasmine, Plovanich Molly, Wallace Elizabeth B, Yang Chao, Canales Alvaro Laga, Mostaghimi Arash
Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
Dermatol Online J. 2016 Nov 15;22(11):13030/qt50v2f3mb.
Nutritional deficiency is rare in developed countries, but can be acquired from decreased nutrient intake, reduced absorption, and increased gastrointestinal excretion. We report a patient with acquired acrodermatitis enteropathica (AE) who exhibited low plasma zinc levels and concurrent nutritional deficiencies (pyridoxine, selenium and fatty acids). Our patient had undergone Roux-en-Y gastric bypass 13 years prior to presentation. The rash, consistent with AE clinically and histologically, nearly resolved one week after starting IV zinc supplementation, total parenteral nutrition, and micronutrient supplements. This case highlights the importance of long-term post-operative follow-up for gastric bypass patients who are at high risk for micronutrient and macronutrient deficiencies and illustrates the potential for rapid improvement with IV supplementation.
营养缺乏在发达国家很少见，但可因营养素摄入减少、吸收降低及胃肠道排泄增加而发生。我们报告了一名获得性肠病性肢端皮炎（AE）患者，其血浆锌水平较低，同时存在营养缺乏（吡哆醇、硒和脂肪酸）。我们的患者在就诊前13年接受了Roux-en-Y胃旁路手术。皮疹在临床和组织学上与AE一致，在开始静脉补充锌、全胃肠外营养和微量营养素补充剂一周后几乎消退。该病例强调了对有微量营养素和宏量营养素缺乏高风险的胃旁路手术患者进行长期术后随访的重要性，并说明了静脉补充剂快速改善的可能性。
