A Rare Case of Severe Acrodermatitis Enteropathica During Covid-19 Lockdown.


  • Taimoor Hussain Bolan Medical Complex Hospital Quetta
  • Jasvindar Kumar Khyber teaching Hospital Peshawar
  • Taimur Aslam Lady reading Hospital Peshawar
  • Saad Khan Khyber teaching Hospital Peshawar
  • Muhammad Ishaq Khyber teaching Hospital Peshawar
  • Daneet Kumar Hayatabad Medical Complex Peshawar.




Acrodermatitis enteropathica, Pakistan, Covid-19 Lockdown, Treatment non compliance


Acrodermatitis Enteropathica is a rare hereditary condition characterized by perioral dermatitis, diarrhea, and alopecia. Etiology includes autosomal recessive inheritance and acquired causes such as protein malnutrition, malabsorption syndromes, premature births, parenteral nutrition, chronic illnesses, and alcoholism. We report a case of a 12-year old boy who presented with cutaneous manifestations involving the whole body, diarrhea, and sparse hairs. A low level of plasma zinc, and alkaline phosphatase level was revealed and he was started on zinc supplements. He significantly improved in a few days, and was discharged after counseling the parents about treatment compliance.  This case highlights importance of early diagnosis, and the importance of treatment compliance in Acrodermatitis Enteropathica. It also stresses the need to take measures to ensure the continuity of health dissemination especially in remote areas.


Schmitt S, Küry S, Giraud M, Dréno B, Kharfi M, Bézieau S. An update on mutations of the SLC39A4 gene in acrodermatitis enteropathica. Hum Mutat 2009;30(6):926–33.

Nistor N, Ciontu L, Frasinariu OE, Lupu VV, Ignat A, Streanga V. Acrodermatitis enteropathica: a case report. Medicine (Baltimore) 2016;95(20):e3553.

Kaur S, Thami GP, Kanwar AJ. Acrodermatitis enteropathica in a full-term breast-fed infant. Indian J Pediatr 2002;69(7):631–3.

Maverakis E, Fung MA, Lynch PJ, Draznin M, Michael DJ, Ruben B, et al. Acrodermatitis enteropathica and an overview of zinc metabolism. J Am Acad Dermatol 2007;56(1):116–24.

Wang K, Pugh EW, Griffen S, Doheny KF, Mostafa WZ, al-Aboosi MM, et al. Homozygosity mapping places the acrodermatitis enteropathica gene on chromosomal region 8q24.3. Am J Hum Genet 2001;68(4):1055–60.

Wang F, Kim BE, Dufner-Beattie J, Petris MJ, Andrews G, Eide DJ. Acrodermatitis enteropathica mutations affect transport activity, localization and zinc-responsive trafficking of the mouse ZIP4 zinc transporter. Hum Mol Genet 2004;13(5):563–71.

Perafán‐Riveros C, França LF, Alves AC, Sanches Jr JA. Acrodermatitis enteropathica: case report and review of the literature. Pediatr Dermatol 2002;19(5):426–31.

Prasad AS. Clinical manifestations of zinc deficiency. Annu Rev Nutr 1985;5(1):341–63.

Dev T, Sethuraman G. Diagnosis of acrodermatitis enteropathica in resource limited settings. BMJ Case Rep 2017;2017:bcr2017220928.

Jensen SL, McCuaig C, Zembowicz A, Hurt MA. Bullous lesions in acrodermatitis enteropathica delaying diagnosis of zinc deficiency: a report of two cases and review of the literature. J Cutan Pathol 2008;35(Suppl 1):1–3.

Ciampo IR, Sawamura R, Ciampo LA, Fernandes MI. Acrodermatitis enteropathica: Clinical manifestations and pediatric diagnosis. Rev Paul Pediatr 2018;36(2):238–41.

Oleske JM, Westphal ML, Shore S, Gorden D, Bogden JD, Nahmias A. Zinc therapy of depressed cellular immunity in acrodermatitis enteropathica: its correction. Am J Dis Child 1979;133(9):915–8.



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