American Society of Hirudotherapy

O08 The elemental clue: a case series of Acrodermatitis enteropathica in a tertiary centre

Case report published in The British journal of dermatology (2025)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Case reportClinical TrialsJassal-Prior P et al. · The British journal of dermatology, 2025

Abstract

Acrodermatitis enteropathica (AE) is a rare disorder of zinc deficiency which may be hereditary or acquired. Hereditary AE is an autosomal recessive disorder caused by defects in the zinc transporter gene SLC39A4, resulting in impaired intestinal absorption of zinc. Acquired AE arises secondary to reduced intake, increased demand, or malabsorption. Zinc, an essential micronutrient plays a key role in immune status, wound repair, gastrointestinal and metabolic function. AE is characterised by diarrhoea, recurrent infections, growth delay and skin manifestations including periorificial and acrodermatitis. We report six cases of AE seen in a tertiary centre. The mean age at presentation was 8 months (5-13 months). All patients presented with a characteristic well-demarcated crusted orofacial erythematous rash together with persistent erosive symmetrical anogenital involvement. One patient had an identified defect in the zinc transporter gene. Four patients (66%) patients were exclusively breast fed and three (50%) were born prematurely. The mean age of presentation among breastfed infants was earlier, at 3.25 months (range: 3-5 months). Low serum zinc levels were documented in 66% of cases. All patients were treated with zinc supplementation and showed rapid clinical improvement following initiation of therapy. This series highlights risk factors for developing acquired AE, including prematurity and exclusive breastfeeding. Breast milk is highest in zinc in the first 1-2 months after which zinc content declines 1, corresponding with the typical age of presentation in breastfed infants. Diagnoses is primality based upon the dermatological presentation demonstrating the importance of clinician familiarity of the presenting -features.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal ArticleCase Reports
Indexed MeSH termsHumansZincAcrodermatitisFemaleMaleInfantCation Transport ProteinsBreast FeedingDietary SupplementsTreatment OutcomeTertiary Care Centers

Summary

Acrodermatitis enteropathica (AE) is a rare disorder of zinc deficiency which may be hereditary or acquired.

Why This Matters for Hirudotherapy

This case series reports six infants with acrodermatitis enteropathica (mean age 8 months) presenting with characteristic periorificial and acral dermatitis, all of whom improved rapidly with zinc supplementation. Risk factors included prematurity (50%) and exclusive breastfeeding (66%), with breastfed infants presenting earlier (mean 3.25 months). The study has no connection to hirudotherapy, leeches, or the leech secretome. The term 'Leech' does not appear in this article's abstract. The only shared domain is wound repair biology, as zinc deficiency impairs healing, but the abstract makes no reference to leech therapy or leech-derived agents in any context.

Citation

O08 The elemental clue: a case series of Acrodermatitis enteropathica in a tertiary centre

Jassal-Prior P et al. · The British journal of dermatology, 2025

Added to ASH library: May 27, 2026 · Site last updated: June 18, 2026

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