(BMJ)—A 16-wk-old, preterm infant presented w/ a 6-wk hx of erythema and crusting over the lips, nose, and small joints of her hands and feet. She was breastfed and had normal development. Viral and bacterial swabs were negative. An oral supplement cleared the rash in 48 h. What is the diagnosis?
Vitamin B12 deficiency
Zinc deficiency
Seborrheic dermatitis
Contact dermatitis
Scurvy
You are correct. The infant's serum zinc level was <2 umol/L (normal range, 10-18). The rash cleared w/in 48 h of oral zinc supplementation at 1 mg/kg/day. Clinicians should consider zinc deficiency in premature infants, even if breastfed, who present with perioral and acral lesions.