The clinical manifestations of zinc deficiency are similar regardless of the cause. Erythematous, scaly, thin papules and coalescing plaques are distributed predominantly in acral locations, on the face and extremities, and, most prominently, around the oral, orbital, genital, and anal orfices. The rash may also involve the trunk. The skin lesions are often erosive, especially in the periorifical locations. Occasionally, bullous or pustular lesions are present. Alopecia is a common feature. Diarrhea, paronychia, stomatitis, apathy, irritability, and failure to thrive occur with varying frequency.