Zinc Responsive Acrodermatitis in Nephrotic Syndrome

224 Indian Dermatology Online Journal | Volume 8 | Issue 3 | May‐June 2017 Sir, A 13‐year‐old boy presented with dark‐colored, itchy skin lesions over both the extremities and back since 6 months. He was previously diagnosed as a case of lichen planus, dermatophytosis, and scabies elsewhere, and was treated unsuccessfully. He was a known case of idiopathic nephrotic syndrome since the age of 7 years and had received oral corticosteroids and cyclosporin. There was no history of aerodigestive distubances. General examination showed cushingoid features. Dermatological examination revealed symmetrical, well‐defined, scaly, hyperpigmented papules, and plaques over the lower extremities, gluteal region, groin, genitalia, elbows, dorsum of hands, and lower trunk, admixed with hypopigmentation and depigmentation [Figure 1a and b], which resolved following treatment with oral zinc [Figure 1c and d]. Face, hair, nails, palms, soles, and mucosae were normal. Provisional diagnosis of acrodermatitis in nephrotic syndrome due to zinc deficiency was made.