Pediatric Acrodermatitis Enteropathica Differential Diagnoses

Updated: Aug 18, 2016
  • Author: KN Siva Subramanian, MD; Chief Editor: Dirk M Elston, MD  more...
  • Print

Diagnostic Considerations

Acrodermatitis dysmetabolica (AD) is a new term used to describe the phenotypic appearance of other conditions that resemble acrodermatitis enteropathica (AE) but are associated with a normal plasma zinc level. Other than acquired zinc deficiency, most differential diagnoses are easily excluded. A successful trial of zinc supplementation confirms the diagnosis. However, if zinc supplementation does not improve the condition, AD should be considered. The following should also be considered:

  • Acquired zinc deficiency of any cause
  • Infants receiving inadequate supplementation in parenteral alimentation
  • Infants who were born prematurely
  • Full-term or premature breastfed infants
  • Infants with malabsorption due to cystic fibrosis, small-bowel resection (especially those undergoing nasogastric decompression), or celiac disease [17]
  • Human immunodeficiency virus (HIV) disease
  • Atypical epidermolysis bullosa (AD)
  • Generalized or localized candidiasis (AD)
  • Abnormal metabolism of essential fatty acids (AD)
  • Seborrheic dermatitis
  • Kwashiorkor
  • Iatrogenic deficiency of branched chain amino acids (isoleucine) in restrictive diets for maple syrup urine disease, methylmalonic aciduria, or phenylketonuria (AD)

Differential Diagnoses