[Acquired zinc deficiency in a breast-fed premature infant]

Acquired zinc deficiency in exclusively breast-fed premature babies is a recently described entity which surprisingly, has not been reported more frequently. Its pathogenesis would appear to be the result of various factors, prematurity, exclusive breast-feeding and a suspected maternal defect, acquired or inherited, for the transfer of zinc from the blood to the breast milk. We report the case of a girl who was born at 31 weeks, exclusively breast-fed for 28 weeks and who presented a characteristic clinical feature of zinc deficiency. The mother's zinc level in the breast-milk was abnormally low. After zinc therapy and progressive weaning, the lesions dramatically improved in few days. There was no recurrence of the lesions one year after the treatment was completely stopped. With regard to this characteristic case, we outline the many pathophysiological mechanisms involved in acquired zinc deficiency. Recognition of this clinical feature by dermatologists seems essential because the required treatment is spectacularly effective and definitive. Finally, we also examine possible forms with few symptoms and we wonder if serum zinc levels should be checked in at-risk babies.