Close
New

Medscape is available in 5 Language Editions – Choose your Edition here.

 

Acrodermatitis Enteropathica Differential Diagnoses

  • Author: Kristina Marie Dela Rosa, MD; Chief Editor: William D James, MD  more...
 
Updated: Oct 06, 2015
 
 

Diagnostic Considerations

Other considerations include the following:

  • Biotin and multiple decarboxylase deficiencies
  • Malabsorption syndromes secondary to cystic fibrosis or intestinal disease[20]
  • Essential fatty acid deficiencies
  • Kwashiorkor
  • Human immunodeficiency virus (HIV) disease
  • Iatrogenic deficiency of branched chain amino acids (isoleucine) in restrictive diets for maple syrup urine disease or methylmalonic aciduria[21]
  • Glutaric aciduria type 1[22]
  • Leucinosis
  • Nonketotic hyperglycinemia[11]

Differential Diagnoses

 
 
Contributor Information and Disclosures
Author

Kristina Marie Dela Rosa, MD Dermatologist, Naval Hospital Camp Pendleton

Kristina Marie Dela Rosa, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association

Disclosure: Nothing to disclose.

Coauthor(s)

Elizabeth K Satter, MD, MPH Dermatologist and Dermatopathologist

Elizabeth K Satter, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Medical Womens Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Michael J Wells, MD, FAAD Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine

Michael J Wells, MD, FAAD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Texas Medical Association

Disclosure: Nothing to disclose.

Edward F Chan, MD Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania School of Medicine

Edward F Chan, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Chief Editor

William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Eleanor E Sahn, MD Director, Division of Pediatric Dermatology, Associate Professor, Departments of Dermatology and Pediatrics, Medical University of South Carolina

Eleanor E Sahn, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Southern Medical Association

Disclosure: Nothing to disclose.

Timothy G Woodall, MD Dermatology, Carolinas Medical Center - Pineville

Timothy G Woodall, MD is a member of the following medical societies: American Academy of Dermatology, American Society for Dermatologic Surgery, South Carolina Medical Association

Disclosure: Nothing to disclose.

Acknowledgements

The view(s) expressed herein are those of the authors and do not reflect the official policy or position of Naval Special Warfare Center, the U.S. Navy Medical Department, the U.S. Navy Office of the Surgeon General, the Department of the Navy, Department of Defense, or the U.S. Government.

References
  1. Perafan-Riveros C, Franca LF, Alves AC, Sanches JA Jr. Acrodermatitis enteropathica: case report and review of the literature. Pediatr Dermatol. 2002 Sep-Oct. 19(5):426-31. [Medline].

  2. Prasad AS. Zinc: an overview. Nutrition. 1995 Jan-Feb. 11(1 Suppl):93-9. [Medline].

  3. Kury S, Dreno B, Bezieau S, et al. Identification of SLC39A4, a gene involved in acrodermatitis enteropathica. Nat Genet. 2002 Jul. 31(3):239-40. [Medline].

  4. Nakano A, Nakano H, Nomura K, Toyomaki Y, Hanada K. Novel SLC39A4 mutations in acrodermatitis enteropathica. J Invest Dermatol. 2003 Jun. 120(6):963-6. [Medline].

  5. Wang K, Pugh EW, Griffen S, Doheny KF, Mostafa WZ, al-Aboosi MM. Homozygosity mapping places the acrodermatitis enteropathica gene on chromosomal region 8q24.3. Am J Hum Genet. 2001 Apr. 68(4):1055-60. [Medline].

  6. Schmitt S, Kury S, Giraud M, Dreno B, Kharfi M, Bezieau S. An update on mutations of the SLC39A4 gene in acrodermatitis enteropathica. Hum Mutat. 2009 Jun. 30(6):926-33. [Medline].

  7. Kilic M, Taskesen M, Coskun T, Gürakan F, Tokatli A, Sivri HS, et al. A Zinc Sulphate-Resistant Acrodermatitis Enteropathica Patient with a Novel Mutation in SLC39A4 Gene. JIMD Rep. 2012. 2:25-8. [Medline]. [Full Text].

  8. Wang K, Zhou B, Kuo YM, Zemansky J, Gitschier J. A novel member of a zinc transporter family is defective in acrodermatitis enteropathica. Am J Hum Genet. 2002 Jul. 71(1):66-73. [Medline]. [Full Text].

  9. Maverakis E, Fung MA, Lynch PJ, et al. Acrodermatitis enteropathica and an overview of zinc metabolism. J Am Acad Dermatol. 2007 Jan. 56(1):116-24. [Medline].

  10. Evans GW, Johnson PE. Zinc-binding factor in acrodermatitis enteropathica. Lancet. 1976 Dec 11. 2(7998):1310. [Medline].

  11. Samady JA, Schwartz RA, Shih LY, Piela Z, Lambert WC, Janniger CK. Acrodermatitis enteropathica-like eruption in an infant with nonketotic hyperglycinemia. J Dermatol. 2000 Sep. 27(9):604-8. [Medline].

  12. Aggett PJ, Atherton DJ, More J, Davey J, Delves HT, Harries JT. Symptomatic zinc deficiency in a breast-fed preterm infant. Arch Dis Child. 1980 Jul. 55(7):547-50. [Medline].

  13. Kiechl-Kohlendorfer U, Fink FM, Steichen-Gersdorf E. Transient symptomatic zinc deficiency in a breast-fed preterm infant. Pediatr Dermatol. 2007 Sep-Oct. 24(5):536-40. [Medline].

  14. Connors TJ, Czarnecki DB, Haskett MI. Acquired zinc deficiency in a breast-fed premature infant. Arch Dermatol. 1983 Apr. 119(4):319-21. [Medline].

  15. Corbo MD, Lam J. Zinc deficiency and its management in the pediatric population: a literature review and proposed etiologic classification. J Am Acad Dermatol. 2013 Oct. 69(4):616-624.e1. [Medline].

  16. Champion RH, Burton JL, Ebling FJG. Textbook of Dermatology. London: Blackwell Science; 1998. 3: 2668.

  17. Roberts LJ, Shadwick CF, Bergstresser PR. Zinc deficiency in two full-term breast-fed infants. J Am Acad Dermatol. 1987 Feb. 16(2 Pt 1):301-4. [Medline].

  18. Zimmerman AW, Hambidge KM, Lepow ML, Greenberg RD, Stover ML, Casey CE. Acrodermatitis in breast-fed premature infants: evidence for a defect of mammary zinc secretion. Pediatrics. 1982 Feb. 69(2):176-83. [Medline].

  19. Garza-Rodríguez V, de la Fuente-García A, Liy-Wong C, Küry S, Schmitt S, Jamall IS, et al. Acrodermatitis Enteropathica: A Novel SLC39A4 Gene Mutation in a Patient with Normal Zinc Levels. Pediatr Dermatol. 2015 May-Jun. 32 (3):e124-5. [Medline].

  20. Schmidt CP, Tunnessen W. Cystic fibrosis presenting with periorificial dermatitis. J Am Acad Dermatol. 1991 Nov. 25(5 Pt 2):896-7. [Medline].

  21. Tabanlioglu D, Ersoy-Evans S, Karaduman A. Acrodermatitis enteropathica-like eruption in metabolic disorders: acrodermatitis dysmetabolica is proposed as a better term. Pediatr Dermatol. 2009 Mar-Apr. 26(2):150-4. [Medline].

  22. Niiyama S, Koelker S, Degen I, Hoffmann GF, Happle R, Hoffmann R. Acrodermatitis acidemica secondary to malnutrition in glutaric aciduria type I. Eur J Dermatol. 2001 May-Jun. 11(3):244-6. [Medline].

  23. Van Wouwe JP. Clinical and laboratory diagnosis of acrodermatitis enteropathica. Eur J Pediatr. 1989 Oct. 149(1):2-8. [Medline].

  24. Glover MT, Atherton DJ. Transient zinc deficiency in two full-term breast-fed siblings associated with low maternal breast milk zinc concentration. Pediatr Dermatol. 1988 Feb. 5(1):10-3. [Medline].

  25. Gonzalez JR, Botet MV, Sanchez JL. The histopathology of acrodermatitis enteropathica. Am J Dermatopathol. 1982 Aug. 4(4):303-11. [Medline].

  26. Mori H, Matsumoto Y, Tamada Y, Ohashi M. Apoptotic cell death in formation of vesicular skin lesions in patients with acquired zinc deficiency. J Cutan Pathol. 1996 Aug. 23(4):359-63. [Medline].

  27. Jensen SL, McCuaig C, Zembowicz A, Hurt MA. Bullous lesions in acrodermatitis enteropathica delaying diagnosis of zinc deficiency: a report of two cases and review of the literature. J Cutan Pathol. 2008 Oct. 35 Suppl 1:1-13. [Medline].

  28. Welsmann K, Kvist N, Kobayasi T. Bullous acrodermatitis due to zinc deficiency during total parenteral nutrition: an ultrastructural study of the epidermal changes. Acta Derm Venereol. 1983. 63(2):143-6. [Medline].

  29. Perez-Maldonado A, Kurban AK. Metabolic Diseases and Pregnancy. Clinics in Dermatology. Elsevier; 2006. 24: 88-90.

  30. Institute of Medicine, Food and Nutrition Board. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganesse, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Available at http://ods.od.nih.gov/FactSheets/Zinc.asp#h3.. Accessed: 9/9/09.

  31. Willis MS, Monaghan SA, Miller ML, et al. Zinc-induced copper deficiency: a report of three cases initially recognized on bone marrow examination. Am J Clin Pathol. 2005 Jan. 123(1):125-31. [Medline].

Previous
Next
 
Sharply demarcated, brightly erythematous periorificial plaque in an infant with acrodermatitis enteropathica.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.