Cow's Milk Protein Allergy Mimicking Acrodermatitis Enteropathica

Cow's milk protein allergy is an adverse immune reaction to one or more of the constituent proteins of milk obtained from any animal, most commonly alpha s 1-casein cow's milk. In many cases, the allergy is genetic in origin. The infants may experience symptoms within minutes after feeding (rapid onset) or commonly after 7-10 days of consuming the cow's milk (slower onset). Many children with cow's milk protein allergy develop symptoms in at least two of the following organ systems: gastrointestinal, skin and respiratory tract. Acrodermatitis Enteropathica (primary or secondary zinc deficiency) can also produce lesions in the skin and also gastro intestinal symptoms which can mimic milk protein allergy and differentiating between these two may be difficult. We are reporting a case of cow's milk protein allergy in an infant, which was initially diagnosed as Acrodermatitis Enteropathica and treated with zinc. The lesions did not subside completely even after achieving adequate zinc levels, but on stopping the cow's milk all the symptoms and signs disappeared completely and there was no recurrence on long term follow up.