Severe zinc deficiency presenting with acrodermatitis during hyperalimentation: Diagnosis, pathogenesis, and treatment

Seven patients developed severe zinc deficiency with acrodermatitis during hyperalimentation. Several of them had other problems such as diarrhea, poor wound healing and mental changes, which may also have been related to zinc deficiency. Three patients were on hyperalimentation for 2 weeks or less when skin lesions first developed, and most patients were receiving regular infusions of plasma. All patients responded to enteral administration of zinc. We conclude that: 1) severe zinc deficiency with acrodermatitis is not a rare complication of hyperalimentation; 2) even short-term hyperalimentation may be complicated by severe zinc deficiency with acrodermatitis; 3) plasma is not an appropriate way to provide zinc supplementation; 4) if intravenous zinc preparations are not available, oral supplementation is usually effective; and 5) all patients undergoing hyperalimentation should receive zinc supplementation and have regular monitoring of their serum zinc level.