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1.
BMC Pediatr ; 24(1): 338, 2024 May 16.
Article in English | MEDLINE | ID: mdl-38755601

ABSTRACT

BACKGROUND: Transient symptomatic zinc deficiency (TSZD), an acquired type of zinc deficiency, is a rare, but probably underrecognized disease, extremely in breastfed premature with low birthweight infants. Its clinical manefestations are similar to Acrodermatitis enteropathica (AE), which is a genetic zinc absorption disorder caused by SLC39A4 gene mutations. This gene encodes a member of the zinc/iron-regulated transporter-like protein (ZIP) family. The encoded protein localizes to cell membranes and is required for zinc uptake in the intestine. TSZD is often misdiagnosed as AE because of their extremely similar manefestations, characterized by a typical rash. Therefore, the differention between them is still a clinical challenging. CASE PRESENTATION: Here, we present a case of TSZD in a 4 month and 23 days female Chinese Yi-ethnic premature with AE-like skin lesions, mainly presenting periorificial, perianal and perineal crusted, eroded, erythemato-squamous eruption. Laboratory examination showed the patient's blood zinc level was significantly decreased. Further sequencing of the SLC39A4 gene showed no mutation in the infant and her parents. Skin lesions significantly improved after 6 days of initial zinc supplementation (3 mg/kg/d), and maintenance treatment with 1 mg/kg/day of zinc was discontinued after 8 months without recurrence. CONCLUSIONS: The clinical manifestations of TSZD and AE are extremely similar, leading to a high rate of clinical misdiagnosis. While genetic analysis of the SLC39A4 gene is a reliable method for differentiating TSZD from AE. It is recommended that SLC39A4 gene test should be performed as far as possible in children with AE-like rash.


Subject(s)
Acrodermatitis , Zinc , Humans , Zinc/deficiency , Zinc/blood , Acrodermatitis/diagnosis , Acrodermatitis/genetics , Acrodermatitis/etiology , Female , Infant , Diagnosis, Differential , China , Cation Transport Proteins/genetics , Infant, Premature , Infant, Newborn , Infant, Premature, Diseases/diagnosis , Infant, Premature, Diseases/genetics , Infant, Premature, Diseases/blood , East Asian People
2.
Ned Tijdschr Geneeskd ; 1682024 Apr 03.
Article in Dutch | MEDLINE | ID: mdl-38568004

ABSTRACT

During the past four decades the number of reported Lyme disease diagnoses in the Netherlands has increased to 27.000 a year, with a yearly incidence of Lyme disease between 111 (95% CI 106-115) to 131 (95% CI 126-136) per 100,000 person years. A large part of all Lyme disease diagnoses concern the skin; in the Netherlands, 77-89% erythema migrans, 2-3% borrelia lymfocytoom and 1-3% acrodermatitis chronica atrophicans. These skin manifestations have a variable clinical expression, reason why they can be difficult to diagnose. Early recognition and treatment is important to prevent the development of systemic manifestations.


Subject(s)
Acrodermatitis , Erythema Chronicum Migrans , Exanthema , Lyme Disease , Skin Diseases , Humans , Acrodermatitis/diagnosis , Acrodermatitis/drug therapy , Acrodermatitis/etiology , Lyme Disease/complications , Lyme Disease/diagnosis , Lyme Disease/drug therapy , Erythema Chronicum Migrans/diagnosis , Erythema Chronicum Migrans/drug therapy , Erythema Chronicum Migrans/etiology , Exanthema/diagnosis , Exanthema/etiology
5.
Ned Tijdschr Geneeskd ; 1672023 03 16.
Article in Dutch | MEDLINE | ID: mdl-36928086

ABSTRACT

We report the case of an otherwise healthy 47 year-old man who presented to the dermatology outpatient clinic with asymptomatic, one sided erythema of his leg, without edema. The diagnosis acrodermatitis chronica atrophicans was made based on positive IgG antibodies to Borrelia burgdorferi.


Subject(s)
Acrodermatitis , Borrelia burgdorferi Group , Lyme Disease , Male , Humans , Middle Aged , Leg , Acrodermatitis/diagnosis , Acrodermatitis/etiology , Lyme Disease/complications , Lyme Disease/diagnosis , Erythema/diagnosis , Erythema/etiology
7.
J Ayub Med Coll Abbottabad ; 34(4): 880-882, 2022.
Article in English | MEDLINE | ID: mdl-36566420

ABSTRACT

Acrodermatitis Enteropathica is a rare hereditary condition characterized by perioral dermatitis, diarrhoea, and alopecia. Aetiology includes autosomal recessive inheritance and acquired causes such as protein malnutrition, malabsorption syndromes, premature births, parenteral nutrition, chronic illnesses, and alcoholism. We report a rare case of a 12-year-old boy who presented with cutaneous manifestations involving the whole body, diarrhoea, and sparse hairs. A low level of plasma zinc, and alkaline phosphatase level was found, and he was started on zinc supplements. He significantly improved in a few days, and was discharged after counselling 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 provision of health facilities especially in remote areas.


Subject(s)
Acrodermatitis , COVID-19 , Male , Humans , Child , COVID-19/complications , Communicable Disease Control , Zinc/therapeutic use , Acrodermatitis/diagnosis , Acrodermatitis/etiology , Diarrhea
8.
Age Ageing ; 51(11)2022 11 02.
Article in English | MEDLINE | ID: mdl-36436008

ABSTRACT

Acrodermatitis enteropathica (AE) is a rare disorder which can be congenital or acquired. The main features are peri-orificial dermatitis, gastrointestinal symptom in the form of diarrhoea, acral dermatitis and alopecia, among others. This report aims to highlight that AE is an important differential diagnosis to consider, when managing older patients with mucosal infections or ulcerations. Here, we present the case of a 68-year-old female with end-stage liver disease who presented with a right inter-trochanteric femoral fracture following a fall and was noted, on admission, to have non-healing mucosal ulcers.


Subject(s)
Acrodermatitis , Ulcer , Female , Humans , Aged , Ulcer/diagnosis , Ulcer/etiology , Acrodermatitis/diagnosis , Acrodermatitis/etiology , Zinc , Vulva
9.
Tokai J Exp Clin Med ; 47(4): 199-203, 2022 Dec 20.
Article in English | MEDLINE | ID: mdl-36420553

ABSTRACT

Zinc deficiency has long been known as acrodermatitis enteric dermatitis (congenital zinc deficiency). On the other hand, acquired zinc deficiency has attracted attention as a familiar disease in recent years. Epidemiological studies in Japan have shown that acquired zinc deficiency is more common than expected. It is also known that serum zinc levels fall markedly with age. In this report, several cases of acquired zinc deficiency that caused cheilitis are described. In all cases, the only symptom was cheilitis, the serum zinc level was low, and all cases were relieved by zinc supplementation. Zinc deficiency is associated with a range of pathological conditions, including mucocutaneous symptoms, delayed wound healing, dysgeusia, anemia, impaired immunity, and retarded growth development disorders. However, zinc deficiency may be overlooked even in cases of cheilitis alone. Especially in intractable cases, it is important to suspect zinc deficiency as one at the differential diagnoses.


Subject(s)
Acrodermatitis , Cheilitis , Humans , Cheilitis/etiology , Cheilitis/complications , Acrodermatitis/diagnosis , Acrodermatitis/etiology , Zinc , Intestine, Small , Japan
10.
Dermatol Online J ; 28(2)2022 Mar 15.
Article in English | MEDLINE | ID: mdl-35670687

ABSTRACT

Acroangiodermatitis (AAD)[KL1] is a rare vasoproliferative disorder often involving the extremities that has been classified into two variants. Mali-type AAD is more common and associated with chronic venous stasis. Stewart-Bluefarb syndrome[KL2], the other variant, is associated with underlying arteriovenous abnormalities. Mali-type AAD is a relatively benign diagnosis but it may mimic more harmful etiologies such as Kaposi sarcoma both clinically and histologically. A 67-year-old woman with a history of varicose veins, deep vein thrombosis, stroke, and obesity presented to our outpatient clinic with verrucous red-brown papules and plaques on her right lower extremity worsening for three years. Biopsy was consistent with a diagnosis of Mali-type AAD. Providers should be aware of AAD and its variants to accurately differentiate it from more harmful entities.


Subject(s)
Acrodermatitis , Arteriovenous Malformations , Sarcoma, Kaposi , Acrodermatitis/diagnosis , Acrodermatitis/etiology , Acrodermatitis/pathology , Aged , Arteriovenous Malformations/complications , Arteriovenous Malformations/diagnosis , Arteriovenous Malformations/pathology , Female , Humans , Leg/pathology , Rare Diseases/complications , Sarcoma, Kaposi/diagnosis , Syndrome
12.
BMC Oral Health ; 22(1): 52, 2022 03 03.
Article in English | MEDLINE | ID: mdl-35241043

ABSTRACT

BACKGROUND: Zinc is mainly absorbed in the duodenum and proximal jejunum, which are removed during pancreaticoduodenectomy (PD). Little is known about the adverse oral events and skin disorders caused by zinc deficiency after PD. Herein, we reviewed studies on the development of zinc deficiency after PD and reported about a patient with zinc deficiency after PD who required home intravenous zinc replacement. CASE PRESENTATION: A 73-year-old woman with glossitis, taste disorder, and acrodermatitis enteropathica-like eruption on her fingers presented to the Division of Dentistry and Oral Surgery 69 days after PD. Her serum zinc level markedly decreased to 30 µg/dL. Oral zinc administration was inadequate to treat hypozincemia after PD; therefore, multi-trace elements were injected intravenously during readmission. Her serum zinc levels recovered, and her lesions gradually improved. Furthermore, a central venous port was implanted to maintain normal serum zinc levels, and she continued self-injecting zinc at home. CONCLUSIONS: Zinc deficiency after PD rarely occurs. The clinical oncologist community, including dentists responsible for the oral care of cancer patients, should be aware of the oral adverse events, such as dysgeusia, glossitis, and oral pain, associated with zinc deficiency after cancer surgery and that induced by chemotherapy or head and neck radiation therapy.


Subject(s)
Acrodermatitis , Pancreaticoduodenectomy , Acrodermatitis/drug therapy , Acrodermatitis/etiology , Acrodermatitis/pathology , Aged , Dietary Supplements , Female , Humans , Pancreaticoduodenectomy/adverse effects , Zinc
18.
Ann Vasc Surg ; 77: 350.e13-350.e17, 2021 Nov.
Article in English | MEDLINE | ID: mdl-34437968

ABSTRACT

Acroangiodermatitis (AAD) is often seen in association with various vascular anomalies such as venous insufficiency, vascular syndromes, and conditions associated with thrombosis. This is the first case reported in the literature associated with arteriovenous fistula stenosis in a patient with chronic kidney disease on hemodialysis. This case is being described for its rarity and to familiarize the clinicians with this unusual complication, especially, to prevent them from thinking of this condition as an infectious complication. It is essential to recognize the uniqueness of the pathophysiology of this disease and to do a clear distinction with that of a venous ulcer. With this work we also aim to help health practitioners with proper management of the condition. As we've seen, surgical treatment in appropriately selected cases corrects the reflux of the venous system and successfully improves the appearance of the verrucous lesion. Our patient was successfully treated by correcting the arteriovenous fistula stenosis with near-complete subsidence of the verrucous lesion within days of the procedure. Acroangiodermatitis management must be conducted with a multidisciplinary approach (dermatology, vascular surgery, and internal medicine). It is essential the comprehensive management of these patients, to ensure prompt recovery and avoid chronic effects, as well as to guarantee the quality of life in the future.


Subject(s)
Acrodermatitis/etiology , Arteriovenous Shunt, Surgical/adverse effects , Graft Occlusion, Vascular/etiology , Hand Dermatoses/etiology , Renal Dialysis , Renal Insufficiency, Chronic/therapy , Acrodermatitis/diagnosis , Adult , Diagnosis, Differential , Graft Occlusion, Vascular/diagnosis , Graft Occlusion, Vascular/physiopathology , Graft Occlusion, Vascular/surgery , Hand Dermatoses/diagnosis , Hemodynamics , Humans , Male , Renal Insufficiency, Chronic/diagnosis , Reoperation , Skin Diseases, Infectious/diagnosis , Soft Tissue Infections/diagnosis , Treatment Outcome , Wound Healing
19.
BMJ Case Rep ; 14(6)2021 Jun 30.
Article in English | MEDLINE | ID: mdl-34193450

ABSTRACT

A 3-month-old, full term female infant, adequate for gestational age, and exclusively breastfed, was admitted with a 10 day history of generalised scaling erythematous dermatitis, affecting the face (perinasal, nasolabial folds and periauricular), acral and intertriginous areas, with irritability and failure to thrive. Her mother had been treated with isoniazid since the third trimester because of family contact with tuberculosis. Based on a diagnosis of suspected impetiginised eczema, the infant was treated with flucloxacillin and prednisolone, and maternal isoniazid was suspended, with no improvement. Investigations found low serum zinc levels in the infant (33 µg/dL; normal range (NR) >60 µg/dL), normal plasma zinc levels in the mother (111.3 µg/dL; NR 68-120 µg/dL) and lower than the normal range of zinc levels in breast milk (270µg/L; NR 1000-2500 µg/L), suggesting acrodermatitis caused by zinc deficiency. Oral zinc supplementation (3 mg/kg/day) was started with a marked improvement in skin lesions, as well as good weight gain. At the age of 6 months, after food diversification, supplementation was suspended, without any recurrence of symptoms.


Subject(s)
Acrodermatitis , Malnutrition , Acrodermatitis/diagnosis , Acrodermatitis/drug therapy , Acrodermatitis/etiology , Breast Feeding , Female , Humans , Infant , Milk, Human/chemistry , Zinc
20.
Pediatr Dermatol ; 38(3): 629-631, 2021 May.
Article in English | MEDLINE | ID: mdl-33641205

ABSTRACT

Since the onset of the COVID-19 pandemic, the growing body of literature has largely focused on the adult population. Reported symptoms among children appear to be consistent with those in adults, including fever, respiratory symptoms, and gastrointestinal symptoms, though children may experience an overall milder disease course. Viral exanthems with possible association to COVID-19 have been reported in pediatric patients. We describe a 10-month-old boy with Gianotti-Crosti syndrome in the setting of recent SARS-CoV-2 RT-PCR positive testing to increase physician awareness and add to the collection of cutaneous manifestations of COVID-19.


Subject(s)
Acrodermatitis , COVID-19 , Exanthema , Acrodermatitis/diagnosis , Acrodermatitis/etiology , Child , Exanthema/diagnosis , Exanthema/etiology , Humans , Infant , Male , Pandemics , SARS-CoV-2
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