Question
A 38-year-old woman with poorly controlled Crohn disease complains to the physician about a 2-week history of hair loss and a rash on her face. She has also noticed that food has recently tasted bland to her. She had to undergo segmental small bowel resection several times because of intestinal obstruction and fistula formation. Examination shows several bullous, erythematous perioral plaques. There are two well-circumscribed circular patches of hair loss on the scalp. A deficiency of which of the following is the most likely cause of this patient’s condition:
| A. | Iron |
| B. |
Selenium |
| C. |
Cobalamin |
| D. |
Zinc |
|
Correct Answer � D Explanation |
 |
Ans. D. ZInc
Zinc deficiency can manifest as immune dysfunction, impaired wound healing, hypogonadism, diarrhea, dermatitis, alopecia, dysgeusia, and dysosmia. Etiologies include poor dietary intake, impaired absorption (due to Crohn’s disease), congenital conditions (e.g., acrodermatitis enteropathica), and liver or renal disease. Because zinc is mainly absorbed in the jejunum, this patient’s Crohn disease and numerous small bowel resections likely disturb physiologic zinc absorption and causing zinc deficiency.