Acrodermatitis Enteropathica: A Case Report Involving a Delayed Diagnosis

Acrodermatitis enteropathica (AE) is a hereditary autosomal recessive disorder caused by a defect in zinc metabolism, leading to a zinc deficiency. We report a case of a two-year-old female infant who presented with psoriasiform-eczematous skin lesions with acral distribution in all four extremities one month after weaning from breast milk at five months old. The patient had no history of diarrhea or hair loss and had been misdiagnosed with tinea corporis and treated with topical and systemic antifungals for a year without benefit. She had also been misdiagnosed as having psoriasis and treated with corticosteroid-calcipotriene for several months without benefit. A skin examination revealed multiple well-defined patches of scaly erythematous plaque on all four extremities, and some of the lesions displayed an annular configuration. The laboratory investigation revealed a low serum zinc level (49.10 ug/dL; normal range: 60-110 ug/dL). Based on the clinicopathological findings, the patient was diagnosed with AE. She was started on 13 mg/kg of zinc sulfate syrup divided into two doses. All skin lesions completely disappeared after two weeks of zinc treatment.