Acquired acrodermatitis enteropathica

A 34-year-old woman with a history of chronic pancreatitis, untreated hepatitis C, depression, intravenous drug use, alcohol abuse, gastritis, and upper gastrointestinal bleed presented with a 2-month history of intractable rash, watery diarrhea, hair loss, poor oral intake, lethargy, and peripheral edema. On examination, she was noted to be cachectic, had pitting pedal edema, and had a thin, dull, erythematous plaque with a rim of desquamation located over both thighs and buttocks (extending to the gluteal cleft, sparing the anal orifice).