a methylmalonic acidemia case presenting with acrodermatitis enteropathica

we encountered a patient with methylmalonic aciduria associated with skin lesions resembling acrodermatitis enteropathica. this child was being fed with a low-protein diet when the skin disorder developed. a deficiency in plasma levels isoleucine, was confirmed. supplementation of a high-caloric, protein-rich diet led to a prompt improvement of skin lesions. we assume that in our patient the skin lesions were the result of malnutrition, rather than being primarily associated with the underlying metabolic disease. to our knowledge, few reports are so far available concerning methylmalonic aciduria complicated by skin eruptions.