2025 – PAGE 164 – DERMATOLOGY
(DOUBLE TAKE) ACRODERMATITIS ENTEROPATHICA
Acrodermatitis enteropathica is an inherited condition (autosomal recessive) in which there is a zinc transport defect. It can result in alopecia, diarrhea, failure to thrive (FTT), and the rash of zinc deficiency.
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(DOUBLE TAKE) BIOTIN/BIOTINIDASE DEFICIENCY
Biotin and biotinidase deficiencies may present with a RASH + ALOPECIA + NEUROLOGIC SIGNS (ataxia, coma, etc.). Patients may also have lactic acidosis. Treat with biotin.
MNEMONICS: Imagine the bio-TIN MAN from The Wizard of Oz walking with an ATAXIC gait as he SCRATCHES his bare arm (NO HAIR)! Also, think of biotin as bio7in to remember that this is vitamin B7.
TELOGEN EFFLUVIUM
Telogen effluvium is a form of acute hair shedding that occurs diffusely. Instead of patches, you see “thinning” of the hair. The hair that is shed can be recognized by a small bulb of keratin on the root end. It was too young to shed. This is often related to a psychological or medical stressor. Treat with REASSURANCE because the hair will grow back.
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TINEA CAPITIS (AKA RINGWORM)
Tinea capitis (ringworm) results in broken hair that looks like “black dot alopecia.” There is often inflammation, and this condition can be associated with a kerion (a raised spongy lesion). Treat with GRISEOFULVIN. You do not need any baseline labs.
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