Hanan Abdul, Rehman Atiq Ul, Abdullah Fnu, Anwar Amna, Umar Muhammad, Shafiq Saba, Rehman Abdur, Iqbal Javed
Khawaja Safdar Medical College, Sialkot, Pakistan.
Ameer-ud-Din Medical College, Lahore, Pakistan.
Case Rep Dermatol. 2025 May 8;17(1):255-262. doi: 10.1159/000544874. eCollection 2025 Jan-Dec.
Acrodermatitis enteropathica (AE) is a rare genetic disorder that results in impaired zinc absorption due to a mutation in the SLC39A4 gene, leading to systemic zinc deficiency with characteristic dermatologic, immunologic, and gastrointestinal manifestations.
This case report presents a 6-year-old boy with recurrent AE, exhibiting widespread vesiculopustular lesions, alopecia, chronic diarrhea, and poor growth, symptoms typical of zinc deficiency syndromes. Initial diagnosis was supported by low serum zinc levels, elevated C-reactive protein, and IgE, indicating an inflammatory process. Despite the absence of genetic confirmation, the clinical and laboratory findings were consistent with AE. Treatment with oral zinc supplementation resulted in rapid symptomatic improvement, underscoring the essential role of zinc in skin integrity and immune function.
This case highlights AE's diagnostic challenges, especially in resource-limited settings lacking access to genetic testing, and the critical need for long-term zinc monitoring to manage recurrent symptoms and prevent toxicity. AE's rare incidence and overlapping symptoms with other dermatologic and metabolic disorders necessitate a high degree of clinical suspicion, emphasizing the importance of zinc in pediatric growth and immune health. This report contributes valuable insights for managing recurrent AE presentations, particularly in contexts with limited diagnostic resources.
肠病性肢端皮炎(AE)是一种罕见的遗传性疾病,由于SLC39A4基因突变导致锌吸收受损,进而引起全身性锌缺乏,并伴有特征性的皮肤、免疫和胃肠道表现。
本病例报告介绍了一名患有复发性AE的6岁男孩,表现为广泛的水疱脓疱性皮损、脱发、慢性腹泻和生长发育迟缓,这些都是锌缺乏综合征的典型症状。血清锌水平降低、C反应蛋白和IgE升高支持了最初的诊断,提示存在炎症过程。尽管缺乏基因确诊,但临床和实验室检查结果与AE相符。口服补锌治疗后症状迅速改善,突出了锌在维持皮肤完整性和免疫功能中的重要作用。
本病例强调了AE的诊断挑战,尤其是在缺乏基因检测条件的资源有限地区,以及长期监测锌水平以管理复发性症状和预防锌中毒的迫切需求。AE的罕见发病率以及与其他皮肤和代谢性疾病的症状重叠,需要高度的临床怀疑,强调了锌在儿童生长和免疫健康中的重要性。本报告为管理复发性AE病例提供了有价值的见解,特别是在诊断资源有限的情况下。