A man in his mid-30s developed a severe, spreading rash that didn’t respond to normal treatments. He had liver disease and digestive problems that put him at risk for nutritional deficiencies. After getting worse and needing hospital care, doctors discovered he had very low zinc levels. When he started taking zinc supplements, his skin cleared up quickly. This case shows that doctors should check for zinc deficiency when patients have stubborn skin problems, especially if they have conditions that affect how their body absorbs nutrients.

The Quick Take

  • What they studied: Whether zinc deficiency could be the hidden cause of a severe, unexplained rash in a patient with liver disease and digestive problems
  • Who participated: One male patient in his mid-30s with alcohol-related liver disease and ulcerative colitis (a condition affecting the digestive system)
  • Key finding: The patient had low blood zinc levels, and adding zinc supplements led to rapid improvement of the rash, suggesting zinc deficiency was the actual problem
  • What it means for you: If you have a stubborn rash that doesn’t improve with normal treatments and you have digestive or liver problems, ask your doctor to check your zinc levels. This is especially important if you have conditions that make it hard for your body to absorb nutrients properly.

The Research Details

This is a case report, which means doctors documented one patient’s medical story in detail. The patient came to the hospital with a widespread rash that kept getting worse despite treatment with steroid creams, antiviral medications, and moisturizers. The doctors ran many tests, including skin biopsies and imaging, but couldn’t figure out what was causing the problem. Eventually, a skin specialist suggested the rash might look like a rare inherited condition called acrodermatitis enteropathica, which is caused by the body’s inability to absorb zinc properly. This led them to test the patient’s zinc levels, which came back very low.

Case reports are important because they can reveal patterns that doctors might miss. This case is valuable because it shows that acquired zinc deficiency (not having enough zinc from poor absorption or diet) can look exactly like a rare genetic condition. By documenting this patient’s journey, doctors can learn to think about zinc deficiency earlier when treating patients with similar risk factors.

This is a single case report, which means it describes one patient’s experience rather than testing many people. While case reports are less powerful than large studies, they can be very valuable for identifying new patterns or reminding doctors about conditions they might overlook. The strength of this case comes from the clear cause-and-effect: the patient had low zinc, received zinc supplements, and improved quickly. However, one case cannot prove that this will happen for everyone with similar symptoms.

What the Results Show

The patient initially presented with a widespread rash that covered much of his body. Standard treatments for contact dermatitis and viral infections did not help, and the rash actually worsened over time. The patient became sick enough to need intensive care admission, and doctors found he had developed pneumonia in both lungs. A skin biopsy was performed but did not provide clear answers about what was causing the rash. A dermatology specialist (skin doctor) noticed the rash pattern resembled acrodermatitis enteropathica, a condition related to zinc absorption problems. Blood tests revealed the patient had significantly low zinc levels. Once zinc supplementation was started, the patient showed rapid improvement in his skin condition, suggesting that zinc deficiency was the underlying cause all along.

The patient’s medical history included two important risk factors: alcohol-related liver disease and ulcerative colitis. Both of these conditions can interfere with how the body absorbs and stores nutrients like zinc. The liver plays a key role in storing zinc, and ulcerative colitis damages the intestines where nutrients are absorbed. These factors together made the patient especially vulnerable to developing zinc deficiency. The case also showed that zinc deficiency can cause severe enough skin problems to require hospitalization, and that the condition can develop in adults even though the genetic form is usually seen in children.

Acrodermatitis enteropathica is a rare inherited genetic condition that has been well-documented in medical literature. This case is notable because it shows that acquired zinc deficiency (developing from poor absorption or inadequate intake) can produce nearly identical symptoms in adults with risk factors. Previous research has recognized that patients with liver disease and digestive disorders are at higher risk for zinc deficiency, but this case highlights how serious the skin manifestations can become if the deficiency goes unrecognized. The rapid improvement with zinc supplementation supports earlier research showing zinc’s critical role in skin healing and integrity.

This is a single case report involving one patient, so we cannot generalize these findings to all patients with similar conditions. The patient had multiple medical problems, making it difficult to know exactly which factor contributed most to the zinc deficiency. The case does not include information about how long the patient had been deficient in zinc before diagnosis, or whether there were earlier warning signs that were missed. Additionally, this case report does not provide long-term follow-up data about whether the patient’s zinc levels remained normal after supplementation or whether the rash stayed cleared.

The Bottom Line

If you have a persistent rash that doesn’t respond to standard treatments, especially if you have liver disease, digestive problems, or conditions affecting nutrient absorption, ask your doctor to check your zinc levels. This is a simple blood test that can reveal an easily treatable cause. If zinc deficiency is found, zinc supplementation appears to be effective, though you should work with your doctor to determine the right dose and duration. Confidence level: Moderate—this recommendation is based on one case, but it aligns with known medical science about zinc’s importance for skin health.

This finding is most relevant to people with liver disease, ulcerative colitis, Crohn’s disease, or other conditions that affect nutrient absorption. It’s also important for people with chronic skin conditions that haven’t responded to standard treatments. Healthcare providers should pay special attention to this in patients with multiple risk factors for malnutrition. People with healthy digestive systems and normal diets are at much lower risk for zinc deficiency and may not need this testing.

In this case, the patient showed rapid improvement after starting zinc supplements, with noticeable skin changes occurring within days to weeks. However, individual responses may vary. It typically takes several weeks to fully replenish zinc stores in the body, so patience is important. If you start zinc supplementation, work with your doctor to monitor your progress and adjust treatment as needed.

Want to Apply This Research?

  • If you’re taking zinc supplements for a skin condition, track daily: (1) Overall rash severity on a scale of 1-10, (2) Specific symptoms like itching, redness, or oozing, (3) Any new skin areas affected, and (4) Zinc supplement dose and timing. Take photos weekly to document visible changes.
  • Work with your doctor to establish a consistent zinc supplementation routine. Set daily reminders to take your supplement at the same time each day, preferably with food to improve absorption. Keep a simple log of when you take it and any changes you notice in your skin. Report back to your doctor at scheduled follow-up appointments with your tracking data.
  • Schedule follow-up blood tests with your doctor at 4-6 weeks and 12 weeks after starting supplementation to confirm zinc levels are normalizing. Continue tracking skin symptoms throughout this period. If you have underlying digestive or liver disease, work with your doctor on a long-term monitoring plan, as you may need ongoing zinc supplementation or dietary adjustments to maintain healthy levels.

This case report describes one patient’s experience and should not be used for self-diagnosis or self-treatment. If you have a persistent rash or skin condition, consult with a qualified healthcare provider or dermatologist for proper evaluation and testing. While this case suggests zinc deficiency can cause severe skin problems, many other conditions can also cause rashes. Only a healthcare professional can determine the actual cause of your symptoms through proper examination and testing. Do not start taking zinc supplements without medical guidance, as excessive zinc can also cause health problems. This information is educational and not a substitute for professional medical advice.