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Picture of the Month

Fred E. Ghali, MD; Joel B. Steinberg, MD; Walter W. Tunnessen Jr, MD
Arch Pediatr Adolesc Med. 1996;150(1):99-100. doi:10.1001/archpedi.1996.02170260103018.
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A 4-MONTH-OLD infant with cystic fibrosis (CF) presented with a 4-week history of a progressive, erythematous rash that began in the diaper area and spread to the face and extremities (Figure 1 and Figure 2). In addition to the rash, she had a 1-week history of low-grade fever, diarrhea, and irritability. The rash failed to respond to topical antibacterial or antifungal agents or topical corticosteroids.

Denouement and Discussion 

Acrodermatitis Enteropathica–like Rash in Cystic Fibrosis 

HISTORICAL BACKGROUND  Danbolt and Closs1 coined the name "acrodermatitis enteropathica" (AE) in 1942 to describe a rash, primarily acrally located, in some infants with diarrhea. Moynahan,2 in 1974, discovered that AE, inherited in some cases in an autosomal recessive manner, was associated with zinc deficiency. Since that time, studies have attempted to elucidate the precise mechanism of the zinc deficiency, with some suggesting impaired zinc absorption secondary to a lack of a certain zincbinding


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