Clinical photograph of an infant displaying periorificial dermatitis associated with acrodermatitis enteropathica (zinc deficiency). This frontal close‑up captures the perioral and periorificial skin with erythematous, scaly plaques, crusting, and fissuring at the oral commissures and surrounding lips. The involved skin is inflamed with a rough, desquamative surface and mild edema; epidermal scaling may be greasy or flaky. Distribution is predominantly periorificial, a pattern typical of zinc‑deficiency dermatitis, though acral involvement may occur in some cases. The image illustrates a classic mucocutaneous eruption seen in congenital/genetic AAC (SLC39A4) or acquired zinc deficiency, and may accompany accompanying symptoms such as diarrhea, irritability, and alopecia in certain patients. Pathophysiology centers on impaired zinc transport and keratinocyte dysfunction, leading to compromised barrier integrity and inflammatory ceruminous changes at skin junctions. Clinically, the finding supports a diagnosis of zinc deficiency dermatitis; zinc level and alkaline phosphatase testing can confirm, and rapid improvement after zinc supplementation is characteristic. Differential diagnoses include seborrheic dermatitis, atopic dermatitis, contact dermatitis, and candidiasis. This image is valuable for education, aiding recognition, differential diagnosis, and monitoring therapeutic response in pediatric dermatology and nutrition clinics. This resource supports clinical documentation and searchable educational annotation.

A series of nine clinical photographs (a-i) illustrating the cutaneous manifestations and therapeutic response of acrodermatitis enteropathica-like lesions in an infant. Images a-f depict the pre-treatment state, characterized by well-demarcated, erythematous, and erosive plaques with overlying scaly crusts and scabs. The distribution is classic for zinc deficiency, primarily affecting the acral and periorificial regions: occipital scalp (a, b), perioral area (c), auricle (d), and the perineal and perianal zones (e, f). Diffuse alopecia and sparse hair growth are also visible on the scalp. Images g-i demonstrate the clinical status after 6 days of oral zinc supplementation, showing rapid and significant improvement. The inflammatory erythema and erosions on the scalp (g) and anogenital region (h, i) have largely resolved, leaving behind smooth skin with minimal residual post-inflammatory changes. This comparison serves as a pedagogical tool for recognizing the diagnostic distribution of zinc deficiency-related dermatitis and its dramatic response to targeted replacement therapy.

Clinical photograph of an infant presenting with classic dermatological manifestations of zinc deficiency, such as acrodermatitis enteropathica or transient neonatal zinc deficiency. The image is split into two panels. The left panel shows the patient's face with characteristic erythematous, desquamative, and crusted lesions in a symetrical distribution. Primary areas of involvement include the perioral region (surrounding the lips), the perinasal area (alar base and nasolabial folds), and the glabella (interbrow region). The right panel displays the diaper area, showing well-demarcated, bright red erythematous patches and desquamation across the scrotum, penis, and perineal/perianal regions. The overall clinical presentation highlights the classic 'periorificial' distribution of skin lesions typical of nutritional or genetic zinc metabolism disorders. These findings are pedagogically significant for distinguishing nutritional deficiencies from common diaper dermatitis or atopic eczema in pediatric patients.