Martínez-Bustamante María Elena, Peña-Vélez Rubén, Almanza-Miranda Enory, Aceves-Barrios Carlos Andrés, Vargas-Pastrana Tonatiuh, Morayta-Ramírez Corona Alfredo Raúl Rodolfo
Servicio de Infectología Pediátrica, Centro Médico Nacional 20 de Noviembre, ISSSTE, Ciudad de México, México.
Servicio de Medicina Interna Pediátrica, Centro Médico Nacional 20 de Noviembre, ISSSTE, Ciudad de México, México.
Bol Med Hosp Infant Mex. 2017 Jul-Aug;74(4):295-300. doi: 10.1016/j.bmhimx.2017.05.002. Epub 2017 Jul 5.
Acrodermatitis enteropathica is a low-incidence disease due to inherited or acquired zinc deficiency. It is characterized by acral dermatitis, alopecia, diarrhea and growth retardation. The dermatological condition may mimic a cutaneous fungal infection or other pathogen-related skin diseases.
We report the case of a female patient of 7 months of age, who was sent to Centro Médico Nacional 20 de Noviembre for suspicion of immunodeficiency and cutaneous mycosis. Her condition began with dermatosis disseminated to the head, trunk and genital region; initial treatment with antifungal and broad spectrum antibiotics was given, without improvement. Upon admission, immunodeficiency and fungal infection were discarded. Acrodermatitis enteropathica was suspected, and corroborated later by low serum zinc levels. Immediately after the start of oral treatment with zinc, the patient showed improvement.
There are multiple differential diagnoses of acrodermatitis enteropathica, which includes cutaneous infections. Therefore, the early recognition of the characteristic lesions favors suspicion, diagnosis and appropriate treatment.
肠病性肢端皮炎是一种由于遗传性或获得性锌缺乏引起的低发病率疾病。其特征为肢端皮炎、脱发、腹泻和生长发育迟缓。皮肤病况可能类似皮肤真菌感染或其他病原体相关的皮肤疾病。
我们报告一例7个月大的女性患者,因怀疑免疫缺陷和皮肤真菌病被送往国立20 de Noviembre医学中心。她的病情始于皮疹扩散至头部、躯干和生殖器区域;最初给予抗真菌和广谱抗生素治疗,但未见改善。入院时,排除了免疫缺陷和真菌感染。怀疑为肠病性肢端皮炎,后来通过低血清锌水平得到证实。开始口服锌治疗后,患者立即出现改善。
肠病性肢端皮炎有多种鉴别诊断,包括皮肤感染。因此,早期识别特征性病变有助于怀疑、诊断和适当治疗。