Acrodermatitis enteropática adquirida: reporte de un caso y revisión de la literatura
Palabras clave:
acrodermatitis, metabolismo del cinc, sulfato de cinc acrodermatitis, zinc, metabolism, zinc sulfate
Resumen
La acrodermatitis enteropática es un raro trastorno producido por la deficiencia de cinc, que puede ser heredada o adquirida. Se caracteriza por la presencia de lesiones en la piel distribuidas en zonas distales o alrededor de orificios, alopecia y diarrea.
Reportamos un paciente de 19 meses con lesiones típicas, confirmadas, con un nivel sérico de cinc 13,3 µg/dl. El paciente recibió 1 mg diario de sulfato de cinc oral y dieta rica en cinc con notable mejoría. A continuación se presenta una revisión de la literatura.
Referencias bibliográficas
1. De Klerk Johanis B.C, Oranje Arnold P. Inherited metabolic disorders and the skin. In: Harper J, Oranje A, Prose N, editors. Textbook of pediatric dermatology. 2th ed Massachusetts: Blackwell Publishing Ltd.; 2006. p. 1980.
2. Brandt T. Dermatitis in children with disturbances of general condition and absence of food. Acta Derm Venereol. 1936; 17:513-6.
3. Moynahan EJ, BarnesKM. Zinc therapy in a synthetic diet for lactose intolerance. Lancet. 1973; 1:676-7.
4. Kaur S, Thami GP, Kanwar AJ. Acrodermatitis enteropathica in a fullterm breast-fed infant. Indian J Pediatr. 2002; 69:631-3.
5. Wang K, Zhou B, Kuo YM, Zemansky J, Gitschier J. A novel member of a zinc transporter family is defective in acrodermatitis enteropathica. Am J Hum Genet. 2000; 71:66-73.
6. Wang K, Pugh EW, Griffen S, Doheny KF, Mostafa WZ, alAboosi MM, et al. Homozygosity mapping places the acrodermatitis enteropathica gene on chromosomal region 8q24.3. Am J Hum Genet. 2001; 68:1055-60.
7. Kury S, Dreno B, Bezieau S, Giraudet S, Kharfi M, Kamoun R, et al. Identification of SLC39A4, a gene involved in acrodermatitis enteropathica. Nat Genet. 2002; 31:239-40.
8. Vardi A, Anikster Y, Eisenkraft A, Shohat M, Abu-Much J, Eisenkraft S, et al. A new genetic isolate of acrodermatitis enteropathica with a novel mutation. Br J Dermatol. 2009; 160:1346-8.
9. Perafán-Riveros C, França LF, Alves AC, Sanches JA Jr. Acrodermatitis enteropathica: case report and review of the literature. Pediatric Dermatology. 2002; 19:426-31.
10. Mancini AJ, Tunnessen WW Jr. Picture of the month: acrodermatitis enteropathica-like rash in a breast-fed, full-term infant with zinc deficiency. Arch Pediatr Adolesc Med. 1998; 152:1239-40.
11. Jen M, Shah KN, Yan AC. Cutaneous changes in nutrition disease. In: Klaus Wolff, Lowell A. Goldsmith, Stephen I. Katz, Barbara A. Gilchrest, Amy S. Paller, David J. Leffell, editors. Fitzpatrick’s dermatology in general medicine. 7th edition. New York: McGraw Hill; 2008. p. 1214-6.
12. Ackland ML, Michalczyk A. Zinc deficiency and its inherited disorders: a review. Genes Nutrition. 2006; 1:41-50.
13. Coelho S, Fernandes B, Rodrigues F, Reis JP, Moreno A, Figueiredo A. Transient zinc deficiency in a breast fed, premature infant. Eur J Dermatol. 2006; 16:193-5.
14. Azevedo PM, Gavazzoni-Dias MF, Avelleira JC, Lerer C, de Sousa AS, Azulay DR. Acrodermatitis enteropathica in a fullterm breast-fed infant: case report and literature review. Int J Dermatol. 2008; 47:1056
15. Shrimpton R, Gross R, Darnton-Hill I, Young M. Zinc deficiency: what are the most appropriate interventions? BMJ. 2005;330:347-9.
16. Aggett PJ, Harries JT. The current status of zinc in health and disease states. Arch Dis Child. 1979; 54:909-17.
17. Sandström B. Consideration in estimates of requirements and critical intake of zinc. Adaption, availability and interactions. Analyst. 1995; 120:913-5
18. Kim PW, Sun ZY, Blacklow SC, Wagner G, Eck MJ. A zinc clasp structure tethers 1ck to T cell coreceptors CD4 and CD8. Science. 2003; 301:1725.
19. Maverakis E, Fung MA, Lynch PJ. Acrodermatitis enteropathica and an overview of zinc metabolism. J Am Acad Dermatol. 2007;56:116-24.
20. King JC, Keen CL. Zinc. Modern nutrition in health and disease. In: Shils ME, Olson JA, Shike M, Ross AC, editors. 9th ed. Baltimore: Williams and Wilkins: 1999; 223-9.
21. Auld DS. Zinc coordination sphere in biochemical zinc sites. Biometals. 2001; 14:271-313.
22. Trumbo P, Yates AA, Schlicker S, Poos M. Dietary reference intakes: vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc. J Am Diet Assoc. 2001; 101: 294-301.
23. Cousins RJ. Metal elements and gene expression. Annu Rev Nutr. 1994; 14:449-69.
24. Frederickson CJ, Koh JY, Bush AI. The neurobiology of zinc in health and disease. Nat Rev Neurosci. 2005; 6:449-62.
25. Jat KR, Marwaha RK, Panigrahi I, Kaur S. Fulminant Candida infection in an infant with acrodermatitis enteropathica. Indian J Pediatr. 2009;76:941-2
26. da Matta Ain AC, dos S. Valente E, Mallozi MC, Sarni RO, Furquim M, Solé D. Acrodermatitis enteropathica-like simulating severe atopic dermatitis: a case report. Allergologia et Immunopathologia. 2008; 36:176-9.
27. Van Wouwe JP. Clinical and laboratory assessment of zinc deficiency in Dutch children. A review. Biol Trace Elem Res. 1995; 49:211-25.
28. Sehgal V, Jain S. Acrodermatitis enteropathica. Clin Dermatol. 2000; 18:745-8.
29. Nelder KH. Acrodermatitis enteropathica and other zinc deficiency disorders. In: Fitzpatrick TB, Eisen AZ, Wolff K, Freedberg IM, Austen KF, editors. Dermatology in general medicine. New York: McGraw-Hill; 1993. p. 1826-32.
30. Richlin VA, García-Zuazaga JA, Beck MJ. What is your diagnosis? Acquired acrodermatitis enteropathica. Cutis. 2008; 81:314, 324-6.
31. 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; 56:116-24.
32. Fischer Walker C, Black RE. Zinc and the risk for infectious disease. Annu Rev Nutr. 2004; 24:255-75.
33. Bales CW, DiSilvestro RA, Currie KL, Plaisted CS, Joung H, Galanos AN, et al. Marginal zinc deficiency in older adults: responsiveness of zinc status indicators. J Am Coll Nutr. 1994; 13:455-62.
34. Grider A, Bailey LB, Cousins RJ. Erythrocyte metallothionein as an index of zinc status in humans. Proc Natl Acad Sci. 1990; 87:1259-62.
35. Crone J, Huber WD, Eichler I, Granditsch G. Acrodermatitis enteropathica–like eruption as the presenting sign of cystic fibrosis: case report and review of literature. Eur J Pediatr. 2002; 161:475-8.
36. Maverakis E, Lynch PJ, Fazel N. Acrodermatitis enteropathica. Dermatol Online J. 2007; 13:11.
37. Lee MG, Hong KT, Kim JJ. Transient symptomatic zinc deficiency in a full-term breast-fed infant. J Am Acad Dermatol. 1990; 23:375-9.
38. Sehgal V, Jain S. Acrodermatitis enteropathica. Clin Dermatol. 2000; 18:745-8.
39. Arlette JP. Zinc deficiency in children. Int J Dermatol. 1982; 21:447-8.
40. Stéphan F, Revuz J. Sels de zinc em dermatologie. Ann Dermatol Venerol. 2004; 131:455-60.
41. Brocks A, Reid H, Glazer G. Acute intravenous zinc poisoning. Br Med J. 1977; 1:1390-1.
2. Brandt T. Dermatitis in children with disturbances of general condition and absence of food. Acta Derm Venereol. 1936; 17:513-6.
3. Moynahan EJ, BarnesKM. Zinc therapy in a synthetic diet for lactose intolerance. Lancet. 1973; 1:676-7.
4. Kaur S, Thami GP, Kanwar AJ. Acrodermatitis enteropathica in a fullterm breast-fed infant. Indian J Pediatr. 2002; 69:631-3.
5. Wang K, Zhou B, Kuo YM, Zemansky J, Gitschier J. A novel member of a zinc transporter family is defective in acrodermatitis enteropathica. Am J Hum Genet. 2000; 71:66-73.
6. Wang K, Pugh EW, Griffen S, Doheny KF, Mostafa WZ, alAboosi MM, et al. Homozygosity mapping places the acrodermatitis enteropathica gene on chromosomal region 8q24.3. Am J Hum Genet. 2001; 68:1055-60.
7. Kury S, Dreno B, Bezieau S, Giraudet S, Kharfi M, Kamoun R, et al. Identification of SLC39A4, a gene involved in acrodermatitis enteropathica. Nat Genet. 2002; 31:239-40.
8. Vardi A, Anikster Y, Eisenkraft A, Shohat M, Abu-Much J, Eisenkraft S, et al. A new genetic isolate of acrodermatitis enteropathica with a novel mutation. Br J Dermatol. 2009; 160:1346-8.
9. Perafán-Riveros C, França LF, Alves AC, Sanches JA Jr. Acrodermatitis enteropathica: case report and review of the literature. Pediatric Dermatology. 2002; 19:426-31.
10. Mancini AJ, Tunnessen WW Jr. Picture of the month: acrodermatitis enteropathica-like rash in a breast-fed, full-term infant with zinc deficiency. Arch Pediatr Adolesc Med. 1998; 152:1239-40.
11. Jen M, Shah KN, Yan AC. Cutaneous changes in nutrition disease. In: Klaus Wolff, Lowell A. Goldsmith, Stephen I. Katz, Barbara A. Gilchrest, Amy S. Paller, David J. Leffell, editors. Fitzpatrick’s dermatology in general medicine. 7th edition. New York: McGraw Hill; 2008. p. 1214-6.
12. Ackland ML, Michalczyk A. Zinc deficiency and its inherited disorders: a review. Genes Nutrition. 2006; 1:41-50.
13. Coelho S, Fernandes B, Rodrigues F, Reis JP, Moreno A, Figueiredo A. Transient zinc deficiency in a breast fed, premature infant. Eur J Dermatol. 2006; 16:193-5.
14. Azevedo PM, Gavazzoni-Dias MF, Avelleira JC, Lerer C, de Sousa AS, Azulay DR. Acrodermatitis enteropathica in a fullterm breast-fed infant: case report and literature review. Int J Dermatol. 2008; 47:1056
15. Shrimpton R, Gross R, Darnton-Hill I, Young M. Zinc deficiency: what are the most appropriate interventions? BMJ. 2005;330:347-9.
16. Aggett PJ, Harries JT. The current status of zinc in health and disease states. Arch Dis Child. 1979; 54:909-17.
17. Sandström B. Consideration in estimates of requirements and critical intake of zinc. Adaption, availability and interactions. Analyst. 1995; 120:913-5
18. Kim PW, Sun ZY, Blacklow SC, Wagner G, Eck MJ. A zinc clasp structure tethers 1ck to T cell coreceptors CD4 and CD8. Science. 2003; 301:1725.
19. Maverakis E, Fung MA, Lynch PJ. Acrodermatitis enteropathica and an overview of zinc metabolism. J Am Acad Dermatol. 2007;56:116-24.
20. King JC, Keen CL. Zinc. Modern nutrition in health and disease. In: Shils ME, Olson JA, Shike M, Ross AC, editors. 9th ed. Baltimore: Williams and Wilkins: 1999; 223-9.
21. Auld DS. Zinc coordination sphere in biochemical zinc sites. Biometals. 2001; 14:271-313.
22. Trumbo P, Yates AA, Schlicker S, Poos M. Dietary reference intakes: vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc. J Am Diet Assoc. 2001; 101: 294-301.
23. Cousins RJ. Metal elements and gene expression. Annu Rev Nutr. 1994; 14:449-69.
24. Frederickson CJ, Koh JY, Bush AI. The neurobiology of zinc in health and disease. Nat Rev Neurosci. 2005; 6:449-62.
25. Jat KR, Marwaha RK, Panigrahi I, Kaur S. Fulminant Candida infection in an infant with acrodermatitis enteropathica. Indian J Pediatr. 2009;76:941-2
26. da Matta Ain AC, dos S. Valente E, Mallozi MC, Sarni RO, Furquim M, Solé D. Acrodermatitis enteropathica-like simulating severe atopic dermatitis: a case report. Allergologia et Immunopathologia. 2008; 36:176-9.
27. Van Wouwe JP. Clinical and laboratory assessment of zinc deficiency in Dutch children. A review. Biol Trace Elem Res. 1995; 49:211-25.
28. Sehgal V, Jain S. Acrodermatitis enteropathica. Clin Dermatol. 2000; 18:745-8.
29. Nelder KH. Acrodermatitis enteropathica and other zinc deficiency disorders. In: Fitzpatrick TB, Eisen AZ, Wolff K, Freedberg IM, Austen KF, editors. Dermatology in general medicine. New York: McGraw-Hill; 1993. p. 1826-32.
30. Richlin VA, García-Zuazaga JA, Beck MJ. What is your diagnosis? Acquired acrodermatitis enteropathica. Cutis. 2008; 81:314, 324-6.
31. 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; 56:116-24.
32. Fischer Walker C, Black RE. Zinc and the risk for infectious disease. Annu Rev Nutr. 2004; 24:255-75.
33. Bales CW, DiSilvestro RA, Currie KL, Plaisted CS, Joung H, Galanos AN, et al. Marginal zinc deficiency in older adults: responsiveness of zinc status indicators. J Am Coll Nutr. 1994; 13:455-62.
34. Grider A, Bailey LB, Cousins RJ. Erythrocyte metallothionein as an index of zinc status in humans. Proc Natl Acad Sci. 1990; 87:1259-62.
35. Crone J, Huber WD, Eichler I, Granditsch G. Acrodermatitis enteropathica–like eruption as the presenting sign of cystic fibrosis: case report and review of literature. Eur J Pediatr. 2002; 161:475-8.
36. Maverakis E, Lynch PJ, Fazel N. Acrodermatitis enteropathica. Dermatol Online J. 2007; 13:11.
37. Lee MG, Hong KT, Kim JJ. Transient symptomatic zinc deficiency in a full-term breast-fed infant. J Am Acad Dermatol. 1990; 23:375-9.
38. Sehgal V, Jain S. Acrodermatitis enteropathica. Clin Dermatol. 2000; 18:745-8.
39. Arlette JP. Zinc deficiency in children. Int J Dermatol. 1982; 21:447-8.
40. Stéphan F, Revuz J. Sels de zinc em dermatologie. Ann Dermatol Venerol. 2004; 131:455-60.
41. Brocks A, Reid H, Glazer G. Acute intravenous zinc poisoning. Br Med J. 1977; 1:1390-1.
Cómo citar
1.
Bohórquez L, Uribe CM, Ruiz AC. Acrodermatitis enteropática adquirida: reporte de un caso y revisión de la literatura. rev. asoc. colomb. dermatol. cir. dematol. [Internet]. 13 de febrero de 2019 [citado 1 de octubre de 2023];17(4):221-6. Disponible en: https://revista.asocolderma.org.co/index.php/asocolderma/article/view/175
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