Individuals with zinc deficiency present with the following signs and symptoms [7] [8]:

• Delayed growth and development
• Fertility issues
• Diarrhea
• Unexplained weight loss
• Loss of appetite
• Development of several skin diseases, such as eczema, acne, alopecia, xerosis, and seborrheic dermatitis
• Delay in wound healing
• Onset of mouth ulcers, stomatittis, burning mouth syndrome and angular cheilitis
• Frequent susceptibility to respiratory infections due to poor immunity
• Delay in onset of puberty and decrease in circulating testosterone

Measuring the plasma levels of zinc, forms the preliminary basis of diagnosis. In infants with acroderatitis enteropathica, the plasma levels are as low as < 50 mcg/dL. Biopsy of the skin or intestinal mucosa is not indicated in diagnosing zinc deficiency [9]. In addition to plasma zinc levels, other studies that provide useful insight for diagnosing zinc deficiency, include urinary excretion of zinc and metabolic balance studies, measuring activities of enzymes that are dependent on zinc, zinc tolerance test and copper:zinc ratio.

In patients with acrodermatitis enteropathica, supplementation of zinc gluconate or zinc sulfate is given at the rate of 1–3 mg/kg/d orally. Through the intravenous route, about 300–1000 mcg/kg/d would be enough for reversal of symptoms. Improvement in symptoms is observed within a period of 5 to 10 days. This should be accompanied, by topical application of petrolatum and warm compresses on areas that are weeping. Such a kind of therapy would promote re-epithelialization. In such cases, lifelong therapy may be necessary [10].

In addition to zinc supplementation, underlying causes of zinc deficiency should also be promptly treated. Individuals are also asked to include food sources of zinc in their daily diet. Dietary sources of zinc include red meat, crab, oysters, pulses, nut, legumes, cheese, fortified breakfast cereals and wholegrain cereals. Including these food sources in the diet, would compensate for losses in zinc [11].

Zinc deficiency can be corrected with appropriate therapy, which includes zinc supplementation. The prognosis of the condition is very favorable, when individuals are given zinc supplementation, depending on their age and physiological status. A survival rate of 100% can be achieved with proper therapy, and treatment in infants with acrodermatitis enteropathica [6].

The acquired form of zinc deficiency is a common phenomenon. Whereas, the inherited form occurs as a result of inborn error in the zinc metabolism. This condition is referred to as acrodermatitis enteropathica. In addition, several other factors also contribute to zinc deficiency, which include improper intestinal absorption, insufficient dietary intake, increased loss and various factors that promote increased secretion of zinc from the body [2].

It has been estimated that newborns suffering from acrodermatitis enteropathica, as a result of zinc deficiency, die within the first few years [3]. Zinc deficiency can affect individuals at any age. Males, as well as females, are equally susceptible to contract such a type of nutritional deficiency.

Zinc deficiency that occurs as a result of improper dietary intake, accounts for 25% of the cases. It is thought to be the leading cause of mortality amongst the infant population. Statistics have revealed that zinc deficiency caused about 176,000 deaths due to diarrhea, and 406,000 deaths due to pneumonia [4].

Zinc is an essential mineral, which serves as an important element for various processes. About 60% of the total zinc content is found in the skeletal tissues, and the rest is found in the bone mass. Deficiency of the zinc also significantly produces loss in the epidermal Langerhans cells. In infants presenting with acrodermatitis enteropathica, a binding ligand goes missing, this significantly contributes to poor absorption of zinc from the breast milk. Genetic mutation in the mother, who is breastfeeding her child, is also known to contribute to development of acrodermatitis enteropathica. High concentration of phytates in certain food groups inhibits the absorption of zinc, favoring its deficiency to set in [5].

For preventing zinc deficiency from setting in, individuals are advised to follow the 5 strategies, which include:

• Agronomic biofortication, which consists of addition of zinc to the soil.
• Fortification, a method which involves addition of zinc to various food sources.
• Inclusion of zinc rich foods to daily diet.
• Oral zinc supplementation to high risk groups, such as children and pregnant and lactating mothers.
• Oral repletion using multivitamin or mineral supplements, which contain zinc sulfate or zinc gluconate.

Zinc is an essential mineral that is required for many body processes. It is necessary for the catalytic activity of approximately 100 enzymes. A daily intake of zinc is essential for maintenance of various processes; this is because, there is no mechanism by which the mineral can be stored in the body. Zinc is also important for immune response, and is also significantly associated with lymphocyte depletion, functioning of the phagocytes, and decreased production of interleukin [1].

• Definition: Zinc deficiency is characterized by a condition; wherein there are lower than normal levels of zinc. This essential trace mineral is important for several body processes, and its deficiency can call for onset of several debilitating conditions. Zinc deficiency is associated with increased incidence of diarrhea, malaria and pneumonia.
• Cause: Various factors contribute to the development of zinc deficiency. These include dietary deficiency, poor intestinal absorption, and increased utilization in conditions of pregnancy, infancy or periods of exercise. In addition to these factors, underlying chronic disease conditions also promote zinc deficiency to set in.
• Symptoms: Zinc deficiency severely affects the mouth, skin, eyes, immune system, cognitive functioning and sense of taste and smell. One of the most important clinical manifestations of zinc deficiency includes the onset of acrodermatitis enteropathica amongst the infants. Individuals with zinc deficiency also suffer from growth retardation, poor cognitive functioning, hair loss, mouth sores, ulcers, xerosis, dermatitis, stomatitis and burning mouth syndrome.
• Diagnosis: Measuring the plasma zinc levels helps in diagnosis of zinc deficiency. Along with evaluation of plasma levels of zinc, diagnostic methods would also include measuring the copper to zinc ratio, urinary excretion of zinc, metabolic balance studies, and measuring the activities of enzymes that are associated with zinc.
• Treatment: Oral zinc supplementation is the most important method to treat zinc deficiency. Intravenous zinc administration is given in severe cases to reverse the symptoms. The inclusion of zinc rich foods in the daily diet is yet another way to improve the zinc status of the affected individuals.

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