Thursday, February 3, 2011

Acrodermatitis enteropathy Symptoms and Diagnosis

Acrodermatitis enteropathy
Symptoms and Diagnosis
Enteropathy dermatitis symptoms appear in the first few months after stopping breastfeeding mother at birth. Physical examination is significant for erythematous patches and plaques, dry, scaly eczematoase evolving, veziculobule, blistering and erosive lesions. Periorificial and acral lesions are distributed on the face, scalp, arms, legs and anogenital. Paronychia and alopecia, eyebrow and eyelash loss are some of the signs. Lesions may become secondarily infected with Staphylococcus aureus and Candida albicans. Children may experience photophobia and anorexia. The reported neurological and behavioral changes, diarrhea. 91% of patients have diarrhea, alopecia 98%, 96% and 100% nail dystrophy dermatitis.
Damage is caused by deficits eye corneal, conjunctival and eyelid. Children experiencing photophobia and blepharospasm, which causes ambilopia in severe cases. Secondary infections of the eyelids are significant. Alopecia of the scalp, eyebrow and eyelash is common. Chronic conjunctivitis, blepharitis, and even scored Keratomalacia keratopathy may complicate the clinical picture. Complications include Sjogren's syndrome and keratitis sicca secondary trichiaza, entropion, swelling, staphylococci and candida infections.
Diagnosis.
Laboratory studies. Enteropathy-lapacientii with acrodermatitis plasma zinc concentration is measured Zinc-accumulation of fetuses in the third trimester of pregnancy intervene so that one will experience early symptoms - The level of zinc in saliva, hair and urine are rarely necessary Alkaline phosphatase-production requires zinc, so it is low -Secondary infections may require therapy and secondary cultures.
Histological examination. Intestinal mucosal biopsy shows loss of architecture with increased infiltration vilozitare lamina propria in patients with acrodermatitis enteropathy. Nuclei are large with an increased distribution of chromatin. Full normalization of the intestinal mucosa is observed after administration of zinc sulphate. Histopathology of skin lesions showed intracellular edema and epidermal pallor. This item is not pathognomonic and can be observed in other nutritional deficiencies.
The differential diagnosis is made with the following conditions: atopic dermatitis, biotin deficiency, candidiasis, epidermolysis bullosa, premature infants, HIV infection, seborrheic dermatitis, Keashiorkor disease.

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