In this issue of the Archives, Darmstadt et al1 remind us of a newly recognized manifesting feature of cystic fibrosis (CF), namely, a persisting dermatitis, perhaps most reminiscent of acrodermatitis enteropathica. Although previously reported,2-4 the nutritional eruption of CF is not generally known to pediatricians, dermatologists, and nutritionists. Hence, this reporting of the largest series, to date, is a welcome addition to the literature and should serve to alert specialists to consider CF early in infants who are thriving poorly and develop an unexplained eruption. I am aware of a modest number of similar, but unreported, cases recognized by pediatric dermatologists.
The nutritional dermatitis of CF can clearly precede significant gastrointestinal and pulmonary symptoms. The present study documented associations with protein-calorie malnutrition as manifested by edema/ hypoalbuminemia in each of their patients as well as low zinc levels in two patients. Studies to document essential fatty acid (EFA) deficiency
Hansen RC. Dermatitis and Nutritional DeficiencyDiagnostic and Therapeutic Considerations. Arch Dermatol. 1992;128(10):1389-1390. doi:10.1001/archderm.1992.01680200099017