Zinc deficiency dermatoses E60

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 04.02.2024

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Characteristic, eczematous, psoriasiform, often microbially superimposed skin changes in acra and body orifices caused by zinc deficiency of various causes, also involvement of skin appendages (hair, nails).

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Different triggers are possible:

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acra, centrofacial, anogenital area, in the chronic form also knee, elbow.

Clinical features
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Acute: episodic papulovesicular, sharply defined eczema. Perioral and perianal erosions, scrotal eczema. Flat blisters in the flexural folds of the fingers and palmae. Delayed wound healing.

Chronic zinc deficiency dermatitis: Eczematous to psoriasiform skin changes, possibly generalized exsiccation eczema, acneiform folliculitis, diffuse alopecia, nail dystrophy, Beau-Reil's transverse furrows of the nails. Other disorders: growth retardation, susceptibility to infections, gastrointestinal disorders, photophobia, mental disorders. See also Acrodermatitis enteropathica.

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Reduction of serum zinc levels and alkaline phosphatase.

Differential diagnosis
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  • Alimentary intake: 33% of the zinc sources in the diet come from meat and meat products, 25% from milk, dairy products and eggs, 20% from cereal products and 20% from other sources.

    Remember! A high calcium content and a low-fat diet worsen the zinc utilization.

  • Drug substitution: Mostly oral, in severe cases parenteral administration of soluble zinc compounds such as zinc sulphate, zinc acetate, zinc lactate under serum zinc level control. Substitution e.g. with unicinc 20-40 mg/day i.v. or 1-2 Tbl./day p.o. In addition protein substitution (zinc is transported in serum bound to albumin). Serum protein control: Desired plasma protein increase (g/l) times plasma volume (l/kg bw) times 2 = amount of protein substitution required (albumin 5-20%).

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  1. Brar BK et al (2003) Acrodermatitis enteropathica-like rash in an exclusively breast fed infant with zinc deficiency. J Dermatol 30: 259-260
  2. Brüske K et al (1987) Zinc and its importance in some dermatological diseases-a statistical analysis. Z Hautkr 62: 125-131
  3. Crone J et al (2002) Acrodermatitis enteropathica-like eruption as the presenting sign of cystic fibrosis--case report and review of the literature. Eur J Pediatr 161: 475-478
  4. Landthaler M et al (1987) Acquired zinc deficiency syndrome. Dermatologist 33: 49-52
  5. Maverakis et al.(2007). Acrodermatitis enteropathica and an overview of zinc metabolism. J Am Acad Dermatol 56: 116-124
  6. Perafan-Riveros C et al (2002) Acrodermatitis enteropathica: case report and review of the literature. Pediatric Dermatol 19: 426-431
  7. Steel M (1988) Zinc deficiency, often not detected - zinc substitution, the therapy of choice. Therapeutic ion 2: 21-27
  8. Weismann K et al (1982) Zinc deficiency dermatoses. Dermatologist 33: 405-410


Please ask your physician for a reliable diagnosis. This website is only meant as a reference.


Last updated on: 04.02.2024