Acrodermatitis enteropathico. Abnormalities of fat metabolism and integumental ultrastructures in infants

Ginsburg, Roy; Robertson, A F; Michel, Beno

doi:10.1001/archderm.112.5.653

Cited by 19 publications

(7 citation statements)

References 21 publications

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“…The association of AE and EFA deficiency has been previously noted (18), although this link has not been consistently seen. Zinc is thought to be the element required in more than 24 metalloenzymes including δ-6-desaturase and δ-5-desaturase, and zinc is also required in the mobilization of dihomo-δ-linolenic acid (19).…”

Section: Discussionmentioning

confidence: 88%

Acrodermatitis Enteropathica-like Eruption Associated with Combined Nutritional Deficiency

Kim

et al. 2005

J Korean Med Sci

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We present here a case of acrodermatitis enteropathica-like eruption associated with essential free fatty acid and protein deficiencies as well as borderline zinc deficiency that occurred after Whipple's operation in a 31-yr-old woman. Her eruptions were improved not by zinc supplements alone, but her condition was improved by total parenteral nutrition including amino acids, albumin, lipid and zinc. Although we could not exactly decide which of the nutrients contributed the most to her manifestations, we inferred that all three elements in concert caused her dermatoses. This case shows that even though the patient's skin manifestations and laboratory results are suggestive of acrodermatitis enteropathica, the physicians should keep in mind the possibility that this disease can be associated with other nutritional deficiencies such as free fatty acid or protein deficiency.

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Section: Discussionmentioning

confidence: 88%

Acrodermatitis Enteropathica-like Eruption Associated with Combined Nutritional Deficiency

Kim

et al. 2005

J Korean Med Sci

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“…been shown to be present in acrodermatitis enteropathica (Cash & Berger, 1969;Ginsburg et al, 1976). Disturbed epidermal sterol metabolism has been recently found in patients with psoriasis (Cooper et al, 1976), though the nature of the disturbance is difFerent from that in EFA deficiency.…”

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confidence: 99%

Essential fatty acid deficient hairless mouse: a model of chronic epidermal hyperproliferation

Lowe

Stoughton

1977

Br J Dermatol

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Epidermal DNA synthesis has been shown to be increased approximately three-fold in hairless mice that were fed a diet deficient in essential fatty acids (EFA deficient) for 65 days, compared with animals fed a standard diet. Autoradiographic labelling indices showed a 330% increase in the EFA deficient mice over controls. The animals developed evidence of a diffuse thickening, scalping and loss of elasticity of the skin after 40 days on the EFA deficient diet. Histologically, the epiderma of the EFA deficient animals showed acanthosis, hypergranulosis, hyperkeratosis and increased intracellular epidermal spaces. Increased mitotic indices were found with Feulgen staining. This is further evidence that deficiencies of essential fatty acids are associated with disturbance of normal epidermal cell proliferation and control of keratinization. A single application of topical 0.1% betamethasone valerate to EFA deficient mice reduced the epidermal DNA synthesis to that of normal diet mice. Ten percent linoleic acid topically over 2 weeks also returned epidermal DNA synthesis to normal levels.

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“…3,4 Acquired zinc deficiency secondary to chronic pancreatitis, Crohn's disease, Whipple procedure, chemotherapy, and essential fatty acid (EFA) deficiency can also present with AE. [5][6][7][8][9][10] Although zinc deficiency has been linked to AE, AE has also been reported in patients with normal serum zinc levels. 11 AE generally responds to zinc supplementation within a few days.…”

Section: Discussionmentioning

confidence: 99%

Acrodermatitis Enteropathica During Adequate Enteral Nutrition

Changela¹,

Javaiya²,

Changela³

et al. 2011

J Parenter Enteral Nutr

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Acrodermatitis enteropathica is a rare skin disorder of zinc deficiency. This case report describes a 91-year-old female nursing home resident who presented with a skin eruption resembling acrodermatitis enteropathica while receiving adequate enteral nutrition (EN) via a percutaneous gastrostomy tube. A low zinc level of 36 mcg/dL confirmed zinc deficiency, and treatment with oral zinc sulfate 220 mg 3 times a day resulted in rapid resolution of the skin lesions. This case supports the notion of close monitoring of patients on long-term EN for clinical manifestations of zinc deficiency, especially in the presence of an unexplained skin rash. Although micronutrient deficiencies are more prevalent in underdeveloped countries and with patients receiving parenteral nutrition, these deficiencies should be kept in mind for patients in developed countries as well as patients receiving EN.

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Acrodermatitis enteropathico. Abnormalities of fat metabolism and integumental ultrastructures in infants

Cited by 19 publications

References 21 publications

Acrodermatitis Enteropathica-like Eruption Associated with Combined Nutritional Deficiency

Acrodermatitis Enteropathica-like Eruption Associated with Combined Nutritional Deficiency

Essential fatty acid deficient hairless mouse: a model of chronic epidermal hyperproliferation

Acrodermatitis Enteropathica During Adequate Enteral Nutrition

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