1. The clinical picture was that of acrodermatitis enteropathica.

2. A patient on long term parenteral nutrition developed acrodermatitis enteropathica-like skin changes.

3. In acrodermatitis chronica atrophicans parenteral antibiotic therapy is sometimes necessary.

4. Acrodermatitis chronica atrophicans follows a peculiar geographical distribution forming clusters of high prevalence in certain regions. Acrodermatitis chronica atrophicans is a clinical manifestation of borreliosis, an infectious disease transmitted by ticks.

5. Perioral dermatitis, labial herpes, acrodermatitis enteropathica and Olmsted syndrome are possible differential diagnoses.

6. The basic defect in acrodermatitis enteropathica (A.E.) is zinc deficiency caused by zinc malabsorption.

7. The histological findings in the fibroid nodes of acrodermatitis chronica atrophicans are described in six cases of our own.

8. Report about a case of Acrodermatitis chronica atrophicans with extreme linear cord-like fibrotic ulnar roll.

9. Acrogamy acrogen acrogenous acrography acrolein acrolepia assectella Acrolepia assectella acrodermatitis in Persian English-Persian dictionary

10. Acrodermatitis enteropathica occurs in two forms: an autosomal recessive inherited form and an acquired form.

11. Acrodermatitis chronica atrophicans is a clinical manifestation of borreliosis, an infectious disease transmitted by ticks.

12. After 16 treatment sessions, the acrodermatitis continua started to improve, and after 24 treatments, had cleared completely.

13. Of the 46 patients suffering from acrodermatitis chronica atrophicans, 14 were treated with ceftriaxone 2g for 15 days.

14. Years after infection, acrodermatitis chronica atrophicans arises at distal body sites causing livid swelling and gradually skin atrophy.

15. Acrodermatitis enteropathica (AE) was diagnosed in 2 siblings, boy and girl, at the age of 10 and 6 weeks.

16. Just as in the autosomal recessive disorder, acrodermatitis enteropathica, the lesions in our patient were caused by zinc deficiency.

17. Classic variants of cutaneous borreliosis are erythema chronicum migrans (ECM), lymphadenosis benigna cutis (LBC) and acrodermatitis chronica atrophicans (ACA).

18. Other possible but rather uncommon differential diagnoses include lichen planus, histiocytosis X, acrodermatitis enteropathica and vitamin B6-deficiency.

19. The classical dermatological symptoms of Lyme borreliosis, erythema migrans, borrelia lymphocytoma and acrodermatitis chronica atrophicans respond to oral antibiotic treatment.

20. Finally, clioquinole was life-saving in acrodermatitis continua in children until this condition was recently identified as a zinc-deficiency syndrome.

21. This disorder presents cutaneous lesions similar to those in papular acrodermatitis of childhood but lacks the characteristic association with hepatitis B virus.

22. In relation to the extent of infiltration a surprising degree of destruction in the connective tissue is caused by acrodermatitis atrophicans Herxheimer.

23. A 60-years old female patient developed juxta-articular fibroid nodules and erythrocyanotic lesions of acrodermatitis chronica atrophicans after several tick bites.

24. Late stages of infection feature chronic plasma-cell rich cutaneous inflammation and acrodermatitis chronica atrophicans in its edematous to atrophic forms.

25. The intestinal resorption of zinc using 65ZnCl2 was estimated in 3 patients with acrodermatitis enteropathica, 2 healthy controls, and 3 heterozygotes.

26. A 30-day duration of treatment with oral antibiotics and not the chosen antibiotic is crucial for curing acrodermatitis chronica atrophicans.

27. Bowel diseases with malabsorption can present on the skin as itching or scaling or as characteristic diseases like pellagra and acrodermatitis enteropathica.

28. The various pathologies are classified as early forms (erythema migrans, borrelia lymphocytom, early neuroborreliosis, carditis) or late forms (arthritis, acrodermatitis chronica atrophicans, chronic neuroborreliosis).

29. Acrodermatitis chronica atrophicans is a dermatological condition that takes a chronically progressive course and finally leads to a widespread atrophy of the skin.

30. They include generalized pustular psoriasis with its subtypes, acrodermatitis continua suppurativa (Hallopeau), acute pustulosis palmopantaris, palmoplantar pustular psoriasis, and pustular variants of a mostly TNF-blocker triggered paradoxical psoriasiform dermatitis.

31. Clinical judgement alone (resolution of the present dermatologic lesion, prevention of later major or minor sequelae) is not sufficient in erythema migrans and acrodermatitis chronica atrophicans.

32. Its steadily increasing clinical spectrum now includes erythema migrans, acrodermatitis chronica atrophicans, lymphadenosis beniga cutis, arthritis, myocarditis, progressive meningoencephalitis, myositis, and various ocular and skin disorders.

33. This is a report on investigations in four patients with acrodermatitis continua suppurativa of all the extremities which revealed in all the patients symptoms of central nervous dysfunctions.

34. In view of the hazard of permanent serious visual damage in patients under treatment for acrodermatitis enteropathica with oxyquinolines a plea is made for thorough ophthalmological surveillance.

35. Only 16% of the neuroborreliosis patients and 32% of the arthritis patients remembered having had an EM. 189 patients (4.8%) with lymphadenosis cutis benigna and 100 patients (2.5%) with acrodermatitis chronica atrophicans were reported.

36. Two cases of Acrodermatitis enteropathica (A. e.) (sister aged 7, brother aged 5), who simultaneously developed pellagroid dermatitis, were examined, as well as their parents, who were second cousins.

37. Secondary syphilis and acrodermatitis chronica atrophicans regularly show a lichenoid infiltrate with interface dermatitis, whereas epidermal involvement is typically absent in erythema migrans, virus exanthema and bacillary angiomatosis.

38. OS has to be differentiated from other severe forms of PPK including Vohwinkel, Clouston, Papillon-Lefèvre or Haim-Munk syndromes, Mal de Meleda, pachyonychia congenita, Tyrosinemia type II and acrodermatitis enteropathica.

39. Zinc deficiency may be caused by a specific absorptive defect present in acrodermatitis enteropathica, by diarrhoea and malabsorption due to disease of the gastrointestinal tract, and by insufficient nutrition.

40. In late stage multiple organ systems can be affected, in Europe especially the skin with various forms of acrodermatitis chronica atrophicans, the central and peripheral nervous system, joints and heartmuscle.

41. Pustular psoriasis of the palms and soles, epidermolysis bullosa hereditaria, hand-foot-mouth-disease, acrodermatitis enteropathica and scabies in children are possible differential diagnoses for vesicles on the palms and soles.

42. After the isolation ofBorrelia burgdorferi, the previously unknown causative agent of Lyme disease, two neurological disorders, Bannwarth's syndrome and acrodermatitis chronica atrophicans-associated neuropathy, which have been known in Europe for decades, gained new interest.

43. They most often affect the skin, nervous system, joints and heart. Cutaneous pseudolymphomas, erythema chronicum migrans of Afzelius, acrodermatitis chronica atrophicans of Pick-Herxheimer, meningo-radiculitis and various arthropathies are the most commonly encountered diseases.

44. We report a case of acrodermatitis enteropathica-like skin eruptions presenting with alopecia, perlèche, glossitis, and genital erosions as well as multifocal eczematoid, psoriasiform, and bullous skin lesions due to zinc deficiency in Crohn’s disease.

45. Acrodermatitis chronica atrophicans is a dermatological condition that takes a chronically progressive course and finally leads to a widespread atrophy of the skin. Involvement of the peripheral nervous system is frequently observed, predominantly a sensory polyneuropathy.

46. Discussion: For diagnosis of borreliosis the most frequently observed dermatological manifestations like erythema migrans, lymphocytosis cutis and acrodermatitis chronica atrophicans Herxheimer, as well as associated dermatosis like lichen sclerosis et atrophicus, granuloma anulare and morphea are reviewed.

47. With vesicles, oozing or bullae: Pustular psoriasis of the palms and soles, epidermolysis bullosa hereditaria, hand-foot-mouth-disease, acrodermatitis enteropathica and scabies in children are possible differential diagnoses for vesicles on the palms and soles.

48. Deficiencies of zinc usually result from unusual diets with high cereal content and little or no animal proteins, and are manifested clinically by such disorders as hypogonadal dwarfism, hepatosplenomegaly, anemia teratogenesis, impaired senses of taste and smell, and dermatologic problems, including acrodermatitis enteropathica.

49. Polymerase chain reaction (PCR) was therefore performed from pretreatment biopsy specimens from lesional skin of 36 erythema migrans patients (m:f=15:21, mean age 49 years) and seven acrodermatitis chronica atrophicans patients (m:f=0:7, mean age 59 years), respectively.

50. The results point at a causal connection between zinc and the pathogenesis of acrodermatitis enteropathica. Ultrastructural alterations of the Paneth cells of the intestine are also shown in this disease [12] as have also been seen in Paneth cells of zinc deficient rats [Beitr.

51. The following drugs are undoubtedly effective and sometimes even the therapy of choice: tetracyclines in acne vulgaris and rosacea (including rosacea keratitis); penicillin G in acrodermatitis atrophicans and cold urticaria; dapsone in dermatitis herpetiformis and — as a powerful adjuvant — in acne vulgaris and rosacea.

52. Significantly elevated antibody titers against ixodid tick spirochetes were observed in 45% of 44 cases with erythema migrans disease, in 72% of 29 cases of lymphocytic meningoradiculitis, in all of nine patients with acrodermatitis chronica atrophicans and in all of four investigated patients with lymphocytoma (lymphadenosis benigna cutis).

53. A remedy for dermatitis comprising one or more compounds selected from the group consisting of (A) zinc compounds and (B) polyvalent unsaturated fatty acids and esters thereof and being highly efficacious against intestinal acrodermatitis and dermatitis seborrhoica showing similar skin symptoms, psoriasis vulgaris, bullous diseases, pruritus cutaneous or symptoms accompanying zinc deficiency caused by trauma, burn or frostbite.

54. We have added 2 case reports to the recently reported cases of acute dermatoses, with lesions resembling those of acrodermatitis enteropathica, associated with total parenteral nutrition and due to zinc deficiency resulting from inadequate intake of zinc and increased excretion of zinc in patients who already may have been depleted from nutritional disturbances that placed them in a catabolic state.

55. Physical Signs of Nutritional Deficiency Disorders System Sign General appearance Skin and hair Reduced weight for height Pallor Edema Nasolabial seborrhea Dermatitis Photosensitivity dermatitis Acrodermatitis Follicular hyperkeratosis (sandpaper-like) Depigmented skin Purpura Scrotal or vulval dermatitis Alopecia Depigmented, dull hair Decreased Poor adaptation to dark Poor color discrimination Bitot’s spots, xerophthalmia, keratomalacia Conjunctive pallor Fundal capillary microaneurysms Angular stomatitis Cheilosis Bleeding gums Atrophic papillae Smooth tongue Red tongue (glossitis) Parotid swelling Caries Anosmia Hypogeusia Goiter Heart failure Hypogonadism Costochondral beading Subperiosteal hemorrhage Cranial bossing Wide fontanel Epiphyseal enlargement Craniotabes Tender bones Tender calves Spoon-shaped nails (koilonychia) Transverse nail lines