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Acrodermatitis enteropathica and the relation to pellagra

I E Krieger

    Medical Hypotheses
    |April 1, 1981
    PubMed
    Summary

    A patient with acrodermatitis enteropathica (AE) improved with picolinic acid (PA) and zinc. This suggests PA deficiency may contribute to skin issues in AE and pellagra.

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    Area of Science:

    • Biochemistry
    • Dermatology
    • Nutritional Science

    Background:

    • Acrodermatitis enteropathica (AE) is a genetic zinc malabsorption disorder.
    • A variant form of AE without hypozincemia presents unique diagnostic and therapeutic challenges.
    • Pellagra, a condition caused by niacin deficiency, shares some clinical similarities with AE skin manifestations.

    Observation:

    • A patient with variant AE showed partial improvement with pancreatic enzymes containing picolinic acid (PA).
    • Plasma zinc levels increased with PA supplementation, even at low zinc doses.
    • The patient experienced complete recovery with zinc supplementation and later maintained elevated zinc with zinc PA and PA alone.

    Findings:

    • Picolinic acid (PA), derived from tryptophan, plays a role in zinc absorption and metabolism.
    • The study demonstrates that PA can increase plasma zinc levels in a patient with AE.
    • This suggests a potential link between PA deficiency and skin manifestations in both AE and pellagra.

    Implications:

    • Picolinic acid (PA) may be a crucial factor in managing certain forms of acrodermatitis enteropathica (AE).
    • The findings propose a novel hypothesis linking PA deficiency to the pathogenesis of skin lesions in AE and pellagra.
    • Further research into the role of PA in tryptophan metabolism and NAD+ synthesis is warranted for understanding these conditions.

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