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Case Reports
. 2011 Dec;23(Suppl 3):S326-8.
doi: 10.5021/ad.2011.23.S3.S326. Epub 2011 Dec 27.

Development of Bullous Acrodermatitis Enteropathica during the Course of Chemotherapy for Acute Lymphocytic Leukemia

Ji Hoon Chun  1 , Ji Hye Baek, Nak Gyun Chung, Jung Eun Kim, Baik Kee Cho, Hyun Jeong Park
Affiliations
Case Reports

Development of Bullous Acrodermatitis Enteropathica during the Course of Chemotherapy for Acute Lymphocytic Leukemia

Ji Hoon Chun et al. Ann Dermatol. 2011 Dec.

Abstract

Acrodermatitis enteropathica (AE) is an uncommon autosomal recessive genetic disorder of zinc malabsorption. The acquired form may be associated with inadequate intake, impaired absorption, and increased excretion of zinc. Those afflicted present with diarrhea, stomatitis, psychiatric symptoms, non-scarring alopecia, and nail dystrophy accompanied by erythematous which appears as scaly patches with erosion vesicles and pustules mostly affecting the extremities, perineal, and periorificial areas. Due to the variable findings of most case reports, the clinical and histopathological features of AE are often regarded as non-specific. We report an unusual case of bullous AE secondary to total parenteral nutrition for the treatment of acute pancreatitis occurring in a six-year-old male with acute lymphocytic leukemia who underwent chemotherapy. He presented with periorificial, reddish, eroded bullae with multiple vesicles and blisters on his fingers, toes, and buttock, showing necrotic keratinocytes with multiple intraepidermal vesicles and perivascular infiltration with predominant lymphocytes and few neutrophils within the dermis. To the best of our knowledge, this is the first case report of bullous AE in the Korean dermatologic literature.

Keywords: Bullous acrodermatitis enteropathica; Chemotherapy; Total parenteral nutrition.

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Figures

Fig. 1
Fig. 1
(A) Abdominal computed tomography showing diffuse edematous swelling of the pancreas (long arrow) and extensive peripancreatic fluid collection (short arrow), (B) reddish, eroded vesicles involving periorificial area, (C) and (D) paronychia with vesicle and blister formation involving fingers and toes.
Fig. 2
Fig. 2
(A) Multiple intraepidermal vesiculation and perivascular infiltration with predominant lymphocytes and few neutrophils within the dermis (H&E, ×40), (B) necrotic keratinocytes and infiltration within the vesicles consisting of lymphocytes and neutrophils (H&E, ×400).
See this image and copyright information in PMC

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References

    1. Danbolt N, Closs K. Akrodermatitis enteropathlca. Acta Derm Venereol (Stockh) 1942;23:127–169.
    1. Jen M, Shah KN, Yan AC. Cutaneous changes in nutritional disease. In: Wolff K, Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, editors. Fitzpatrick's dermatology in general medicine. 7th ed. New York: McGraw-Hill; 2007. pp. 1214–1216.
    1. 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):1–13. - PubMed
    1. Kanekura T, Tashiro M. Zinc deficiency: report of three cases. Cutis. 1991;48:161–164. - PubMed
    1. Ferrándiz C, Henkes J, Peyrí J, Sarmiento J. Acquired zinc deficiency syndrome during total parenteral alimentation. Clinical and histopathological findings. Dermatologica. 1981;163:255–266. - PubMed

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