|Year : 1989 | Volume
| Issue : 4 | Page : 197-198
Acrodermatitis enteropathica-A case report
K Vasantha, K Ananda Kannan
Assistant Professor of Ophthalmology, Regional Institute of Ophthalmology, Egmore, Madras - 600 008, India
Assistant Professor of Ophthalmology, Regional Institute of Ophthalmology, Egmore, Madras - 600 008
Acrodermatitis enteropathica is a rare disease affecting infant girls. The skin in these cases develop rashes which start as vesicles and then dries to form erythematous squamous psoriasiform type of lesions. Dystrophy of nails and alopecia with loss of eye lashes and eye brows is also seen. Low serum zinc level is found in these patients and is thought to be the cause of this disease.
|How to cite this article:|
Vasantha K, Kannan K A. Acrodermatitis enteropathica-A case report. Indian J Ophthalmol 1989;37:197-8
| Case report|| |
A 9 year old boy was referred to us from the Skin Department of the General Hospital, for the complaints of photophobia and defective vision since 3 months.
Upto the age of 3 years the child was normal. After that he developed aloepecia and rashes over the face, knees, elbows and perianal region. There was history of fever on and off during these years.Though the defective vision and photophobia were present for the past 6 years it had become worse during the last 3 months.
| Family history|| |
This is the second child in the family. The first child died at the age of 18 months. The exact cause of death is unknown. The third child, a girl is normal. There is no family history of similar illness.
On examination the patient had only counting fingers in both the eyes. The skin over the eye lids was shiny and hyperpigmented with ulcerative blepharitis and conjuctival xerosis. The cornea was hazy and the sensation was diminished. Both superficial and deep vascularisation were seen. The lens was cataractous in both eyes.
| General examination|| |
There were multiple discete scattered horny papules over the scalp, trunks and shoulders. Scaly lesions were seen over the elbow, knees, perianal region and retro auricular region. Dystrophic changes were seen on both toe nails and finger nails.
| SCHIRMER'S TEST|| |
This showed about 10 mm of wetting, Schirmers I showed 8 mm wetting. Tear film break up time was less than 10 seconds. Other investigations like the routine blood tests were normal. Serum alkaline phosphatase was 8.6 units. Following administration of Homatropine drops twice daily, Methyl cellulose drops and zinc orally, the patient was able to open the eyes well and the dermatitis also improved. There was no significant imment in vision due to the presence of lens changes.
| Comments|| |
Acrodermatitis enteropathica was fist described by Brandt in 1936. It is most probably transmitted by a recessive gene and is said to depend on a disturbance of the metabolism of tryptophan or other essential amino acids. It is an insidious disease occuring in early life characterised by diarrhoea, alopecia and a cutaneous eruption which may involve the eye lids also. Secondary infection with candida is very common and some observers consider that the disorder is due to a genetic susceptibility to this organism. The disease tends to improve after puberty if the child survives Diodoquin 400 mg to 600 mg daily is effective but this drug may induce cataract.
A band shaped opacity concentric to limbus on the upper part of the cornea with radiating lines from it also has been demonstrated. Conjuncticvitis, blepharitis and photophobia are the most common affections seen in these cases.
We are presenting a rare case of acrodermatitis enteropathica.
We are thankful; to the Professor of Dermatology, GH for his opinion and The Director of Regional Institute of Ophthalmology for his permission to present this paper.
| References|| |
|1.||Duke Elder VoI.Vlll Part I, 560 and Vol.XIII Part 1,338. |
|2.||Merit] Grayson, Diseases of the Cornea, 559-561. |
|3.||Ketola, G.H., influence of dietary zinc on cataract in rainbow trouts, the J.of Nutro, 109(6), 965-969, 1979. |
|4.||Acrodermatitis enteropathica, Archives of Ophthal.,93,194,93;140,1975. |