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Successful treatment of acrodermatitis enteropathica with zinc sulfate
Insights
Acrodermatitis enteropathica (AE) is a genetic disorder. This case report details successful treatment of a child with AE using zinc sulfate, significantly improving skin lesions and zinc levels.
Area of Science:
- Pediatric Dermatology
- Nutritional Deficiencies
- Genetic Disorders
Background:
- Acrodermatitis enteropathica (AE) is a rare genetic disorder of zinc absorption.
- Early diagnosis and management are crucial for preventing severe complications.
Observation:
- A 22-month-old child presented with recurrent oral and cutaneous candidiasis, progressing to secondary infections.
- Initial treatments with antifungals and antibiotics were ineffective, leading to a worsening condition.
Findings:
- Laboratory studies revealed a low serum zinc level (60 microgram/dl).
- Treatment with oral zinc sulfate (50 mg t.i.d.) resulted in 99% resolution of skin lesions within 17 days.
- Serum zinc levels increased to 118 microgram/dl post-treatment.
Implications:
- This case highlights the importance of considering zinc deficiency in infants with persistent skin conditions.
- Prompt zinc supplementation can effectively manage acrodermatitis enteropathica, preventing long-term sequelae.
- Further research into the pathogenesis and optimal treatment strategies for AE is warranted.
Abstract:
A case of a 22-month-old child with acrodermatitis enteropathica (AE) is reported. At five months of age, the patient experienced generalized oral and cutaneous candidiasis for which she was treated with nystatin and iodochlorhydroxyquin-hydrocortisone. She then had to be treated for secondary infection of the lesions. After three months, the cycle repeated, and the patient was treated with topical clotrimazole, Mycolog (nystatin, gramicidin, neomycin sulfate, triamcinolone acetonide) and oral nystatin. After a worsening of her condition, she was admitted to a hospital where she was treated initially with procaine penicillin G, then methicillin sodium and gentamicin sulfate. Treatment with zinc sulfate, 50 mg t.i.d., was initiated when laboratory studies showed a serum zinc level of 60 microgram/dl. Skin lesions were 99% resolved and serum zinc increased to 118 microgram/dl after 17 days of zinc sulfate therapy. Previous case reports and studies of the clinical features, treatment and pathogenesis of AE are reviewed.
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