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Living with Hereditary acrodermatitis enteropathica

An inherited zinc absorption problem that causes a skin rash, diarrhea, and nail changes in infants.

Understanding Hereditary acrodermatitis enteropathica

Hereditary acrodermatitis enteropathica is a disorder of zinc metabolism in which the intestine cannot absorb zinc.

Low zinc can cause a rash with pustules around the mouth or anus, diarrhea, and abnormal nails. Irritability and emotional changes can also occur. It starts in the newborn period or infancy. GARD says an acquired form can also come from diets without enough zinc.

Signs & symptoms

Symptoms vary from person to person. GARD lists these among the most common:

  • Skin rash with blisters
  • Long-lasting diarrhea
  • Hair loss (alopecia)
  • Abnormal or ridged nails
  • Sore lips and tongue
  • Slow weight gain (failure to thrive)

Not everyone has every symptom. GARD's list comes from the Human Phenotype Ontology.

Diagnosis

  1. Talk with your doctor

    Share the symptoms you've noticed, when they started and your family health history. Notes and photos can help.

  2. See a specialist

    Specialists who may be involved include digestive system specialists, genetic specialists and skin, hair, and nail specialists.

  3. Consider genetic testing

    Changes in SLC39A4 are linked to this condition. Genetic testing and counseling can help confirm a diagnosis and explain what it means for your family.

Care & treatment

Care team
Digestive system specialists (gastroenterologists); Genetic specialists (geneticists); Skin, hair, and nail specialists (dermatologists)
Expert care
Ask about multidisciplinary care centers for rare conditions
Treatment
GARD doesn't list specific treatments for this condition. Your care team will tailor care to your symptoms.
Research
Clinical trials and observational studies may be options. See the research section below.

General information, not medical advice. Your care team makes the decisions.

Everyday life

Living with a rare condition is easier with support.

  • Connect with Children's Skin Disease Foundation
  • Keep notes on symptoms, changes and questions for appointments
  • Ask about patient registries that help research
  • Look into financial aid and travel resources for care visits
Bring these questions to your next doctor visit
Could genetic testing for the SLC39A4 gene confirm the diagnosis?
How is zinc level monitored?
How can we tell the inherited form from the acquired form?

Quick facts

Symptoms usually startNewborn and as an Infant
InheritanceAutosomal Recessive
GenesSLC39A4

It is caused by changes in the SLC39A4 gene. It is autosomal recessive, so a child inherits a changed copy of the gene from each parent.

GeneticGastrointestinalSkinInherited Metabolic

Also known as: acrodermatitis enteropathica; acrodermatitis enteropathica, zinc deficiency type; ae - acrodermatitis enteropathica; aez; brandt syndrome; danbolt-close syndrome

Patient organizations

Broader rare-disease groups

Source: NIH GARD · Hereditary acrodermatitis enteropathicaGARD ID 5723 · GARD page updated September 2026 · Plain-language summary by Know Rare; editorial review pending. General information, not medical advice.

You are more than your diagnosis

Perspectives from people navigating life with Hereditary acrodermatitis enteropathica.

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