아토피피부염으로 오인된 아연 결핍증1례
A Case of Zinc Deficiency Dermatitis in Breast Milk Fed Infant Mimicking Atopic Dermatitis
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초록
아연 결핍으로 인한 피부증상은 홍반성 인설, 습진성 혹은 수포성 병변이비순구-음낭 등의 회음 부위, 신전 부위에나타나고 곰팡이나 세균의 중복 감염이 잘 발생할 수 있어아토피피부염과감별 진단해야하고, 식이제한으로 아토피피부염 환자에게 아연이 부족하기 쉬워 아토피피부염 병변을 악화시킬 수도 있다. 저자들은 출생 2주 후 부터 발생한입 주위, 항문 주위 및 두정부, 첨단 부위의 피부 병변으로,아토피피부염으로 오인되었던 6개월 된 모유 수유아에서모유 내 아연 부족으로 초래된 아연 결핍을 진단하고 아연보충 후 빠른 호전을 보이고 재발이 없었던 환아를 경험하였기에 보고하는 바이다.
Abstract
Zinc deficiency can result from acrodermatitis enteropathica, an inadequate dietary intake, malabsorption,increased body loss, or intravenous feeding. Unlike acrodermatitis enteropathica, breast feeding-induced acrodermatitis is transient and improves when nursing ends. Breast feeding-induced acrodermatitis is caused by a ZnT-2 transporter dysfunction in the mother’s mammary glands. We report a case of a 6-month-old male infant who presented with erythematous patches and plaques involving the perioral, perineal, and acral areas and loose stools since 2 weeks after birth. Atopic dermatitis was considered initially, but the lesions did not respond to topical antibiotics, corticosteroids,or maternal dietary restriction from allergenic food. The patient’s serum zinc concentration was low, and the mother’s serum and milk had low zinc levels. The differential diagnosis for atopic dermatitis is extensive. Physicians should be alert for the possibility of zinc deficiency dermatitis in breast milk fed infants that mimics atopic dermatitis.
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