Acrodermatitis enteropathica-like eruption and food allergy.
BACKGROUND
Acrodermatitis enteropathica-like eruption (AE) is a distinct rash associated with profound zinc deficiency. It is seen in a variety of conditions but has not been reported as a presentation of food allergy.


OBJECTIVE
To report AE as an unusual presentation of food allergy in infants.


METHODS
Acrodermatitis enteropathica-like eruption was diagnosed by a characteristic rash and a low serum zinc level. The diagnosis of food allergy was made by history, serum total IgE and food specific IgE levels, or oral challenge with suspected foods.


RESULTS
Two infants with AE, diarrhea, and low serum zinc levels were evaluated. Food allergy was found in both infants. The first infant had a serum IgE level of 4642 IU/mL. Specific IgE levels to milk, soybean, wheat, and peanut were 39.04, 10.14, 5.65, and 102.61 kU/L, respectively. Oral challenges to milk and peanut were positive and to soybean were negative. The second infant had a serum IgE level of 991 IU/mL; specific IgE levels to soybean and milk were 36.9 and 0.53 kU/L, respectively. Evaluation for other possible causes of diarrhea revealed homozygous delta F508 in the first infant, confirming the coexistence of cystic fibrosis; findings in the second infant were negative.


CONCLUSIONS
Undiagnosed food allergy can lead to profound zinc deficiency. Food allergy should be suspected in a child with acquired AE.
Martin
Diana P
DP
Department of Pediatrics, University of South Florida/All Children's Hospital, St Petersburg, Florida 33701, USA.
Tangsinmankong
Nutthapong
N
Sleasman
John W
JW
Day-Good
Noorbibi K
NK
Wongchantara
Danita R
DR
D000169:Acrodermatitis / Q000276:immunology*; D003550:Cystic Fibrosis / Q000150:complications; D003967:Diarrhea / Q000276:immunology*; D005512:Food Hypersensitivity / Q000150:complications / Q000276:immunology*; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D007223:Infant; D008297:Male; D015032:Zinc / Q000172:deficiency / Q000276:immunology
D007073:Immunoglobulin E; D015032:Zinc