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Acrodermatitis Enteropathica: Treatment, Cost and Side Effects

Last Updated: Apr 25, 2024

What is the Acrodermatitis Enteropathica?

Acrodermatitis enteropathica is a disease caused by zinc deficiency. Zinc disorder can be acquired or inborn. When zinc deficiency is inherited it is mainly due to autosomal recessive disorder. In case of acquired zinc deficiency which is more common the absorption of zinc by the intestinal cells is improper. The disease is characterized by inflammation around any opening in the body like the mouth and anus region, hair loss, diarrhea and inflammation and discolouration in fingers and toes. The inflammation or skin rashes generally cause discomfort and may be assisted by extreme mood swings and may be infected by bacteria such as Candida Albicans or Staphylococcus aureus.

The inherited kind of the disease is generally seen in infants. Babies who are bottle-fed and those who are weaned from breast milk become prone to zinc deficiency. Zinc is best absorbed from human milk and is required by body for growth and development of the bones. It generally occurs because the mother does not have the zinc-bindind factor produced by the pancrease or her breast milk may be lacking in zinc The symptoms usually start appearing few weeks after birth in both male and females. In adults the cause of zinc deficiency is caused by different reasons like- inadequate zinc in the diet, intestinal malabsorption, excessive urinary loss of zinc and necrolytic migratory erythema ( a rash occurring in the glucagonoma syndrome).

How is the Acrodermatitis Enteropathica treatment done?

The diagnosis for the disease generally involves light microscopy and eclectron microscopy. Additionally there will be blood count and plasma zinc level test for proper treatment of the disease.

Once proper diagnosis is done, acrodrematitis enteropathica is generally treated by giving zinc supplements. Ideally 3 to 1 mg/kg of zinc have to be given orally per day of life to infants or children. Zinc supplements are given in the form of zinc gluconate or zinc sulphate. However, zinc gluconate is usually better absorbed by the body than zinc sulphate. Zinc can also be given during pregnancy. Once the zinc dosage starts to be given, clinical improvement occurs faster than increase in the plasma level of zinc in the body. The inflammation on the skin around the mouth and anus region usually starts to disappear after one to two weeks. Other symptoms like diarrhea and irritability also starts to get better within 24 hours. However, secondary bacterial skin lesions or rashes need antibiotic therapy. To treat the skin lesion and rashes warm compress is given to remove the crusting of the skin and is followed by the application of white petrolatum to heal the skin.

Moreover, the zinc deficiency occuring during pregnancy can also be traeted by giving zinc supplements

Who is eligible for the treatment? (When is the treatment done?)

Acrodermatitis enteropathica is generally seen in babies and infants. It is mainly inherited and the symptoms range from inflammation around the mouth, eye, nose,ear and anus region. Additionally, symptoms like diarrhea, irritibality and hair loss can be seen

Who is not eligible for the treatment?

Infants who do not show any signs or symptoms of acrodermatitis enteropathica are not eligible. Also, adults having neglible zinc deficiancy and needs only medication are not eligible for the treatment.

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Are there any side effects?

As acrodermatitis enteropathica is caused by zinc deficiency and requires lifelong dosage of zinc supplements, side effects are minimal. The disease is mostly seen in babies and infants and is generally inherited from the parents which makes it more fatal to the development and growth. Some of the side effects may include dizziness and copper deficiency that can lead to anaemia and gastrointestinal problems. However, it’s important to remember that zinc is non-toxic and causes no harm to body but its prolonged dosage can result in the above mentioned risks to your babies health in the long run.

What are the post-treatment guidelines?

The post-treatment guidelines for acrodermatitis enteropathica depends on the cause of the disease. As zinc deficiency is either acquired or inherited. In case of acquired zinc deficiency, the post-treatment and treatment are practically the same with zinc supplements and having a diet rich in zinc. However, if it is inherited, then its occurrence is restricted to infants and babies. Therefore, it becomes essential to follow the post-treatment guideline diligently. As zinc supplements are given lifelong, it is important to go for tests every 3 to 6 months to measure the amount of zinc in the body. Moreover, try to include more zinc rich foods and also follow up with the doctor .

How long does it take to recover?

Recovery usually depends on the severiity of the disease. Within a weekor two of taking zinc supplements orally, various symptoms such as skin rahes and inflammation, diearhea and others starts to disappear. However, the level of zinc in the body may not increse within this period.

What is the price of the treatment in India?

The price includes medicial charges and doctoral consultation that can range from Rs. 600 to Rs. 1000. However, the medical charges may increase as the zinc supplements are taken lifelong.

Are the results of the treatment permanent?

The results of the treatment is not permanent as you require lifelong zinc supplements which only leads to eradication of symptoms but does not translate into an increase in zinc level in the body.

What are the alternatives to the treatment?

Alternatives include having zinc rich foods in your diets that will lead to incraese in zinc level in the body.

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Written ByDr. Pankaj Verma ACLS,POST GRADUATE COURSE IN RHEUMATOLOGY,Fellowship in Diabetes,MBBS,Post Graduate Course In Rheumatology,MD - Medicine,Masters in Psychotherapy and CounsellingInternal Medicine
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