Acrodermatitis enteropathica -like syndrome in a subject with pareneteral nutrition.

Abstract

A 28-year-old woman was first observed
due to acrolocated and periorificial skin lesions. From
10 years of life she had gait and equilibrium disorders,
so that after several hospitalizations she had received
a diagnosis of cerebello-pyramidal syndrome of likely
metabolic origin. She had been clinically stable until
August, 2009 when due to dysphagia for solids and liquids,
epigastralgia and vomiting, percutaneous endoscopic
gastrostomy was performed. In July 2010 she
underwent gastric perforation leading to place a central
venous catheter and start parenteral nutrition. After 6
months she started to experience limb and periorificial
skin lesions, diarrhea and hair loss. The presence of
burn-like lesions led us to the determine plasma zinc,
that resulted 19 mg/dl (n.v. 70-120). The administration
of zinc sulfate 60 mg 3 times daily induced a rapid remission
of symptoms, leading to the final diagnosis of
acquired acrodermatitis enteropathica-like syndrome.