Secondary Acrodermatitis Enteropathica in a Premature Low-Birth-Weight Infant: A Case Report

Acrodermatitis enteropathica (AE) is a rare disorder of zinc deficiency that can be hereditary or acquired. Secondary AE is uncommon in premature infants and may mimic other inflammatory or infectious dermatoses, making early diagnosis challenging. A four-month-old premature Egyptian female infant, born at 27 weeks' gestation with a birth weight of 880 g, presented with a one-month history of progressive periorificial and acral dermatitis associated with intermittent diarrhea. The lesions failed to respond to multiple courses of antibiotics. Histopathological findings, together with the clinical presentation and low zinc levels, supported the diagnosis of secondary AE. Oral zinc supplementation resulted in marked clinical improvement. This case highlights the importance of considering secondary AE in premature, low-birth-weight infants presenting with characteristic dermatitis. Early recognition and timely zinc supplementation are essential to prevent complications and achieve favorable clinical outcomes.