Acrodermatitis enteropathica during adequate enteral nutrition.
Acrodermatitis enteropathica is a rare skin disorder of zinc deficiency. This case report describes a 91-year-old female nursing home resident who presented with a skin eruption resembling acrodermatitis enteropathica while receiving adequate enteral nutrition (EN) via a percutaneous gastrostomy tube. A low zinc level of 36 mcg/dL confirmed zinc deficiency, and treatment with oral zinc sulfate 220 mg 3 times a day resulted in rapid resolution of the skin lesions. This case supports the notion of close monitoring of patients on long-term EN for clinical manifestations of zinc deficiency, especially in the presence of an unexplained skin rash. Although micronutrient deficiencies are more prevalent in underdeveloped countries and with patients receiving parenteral nutrition, these deficiencies should be kept in mind for patients in developed countries as well as patients receiving EN.
Department of Internal Medicine, The Brooklyn Hospital Center, Brooklyn, New York 11201, USA. aachange@gmail.com
Avani
A
Changela
Hemangkumar
H
Javaiya
Kinesh
K
Changela
Evangelia
E
Davanos
Kiersten
K
Rickenbach
D000169:Acrodermatitis / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D000369:Aged, 80 and over; D003677:Deficiency Diseases / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D004750:Enteral Nutrition / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D009751:Nutritional Requirements; D012867:Skin / Q000473:pathology*; D015032:Zinc / Q000097:blood / Q000172:deficiency* / Q000627:therapeutic use; D019287:Zinc Sulfate / Q000627:therapeutic use*
D019287:Zinc Sulfate; D015032:Zinc