Background: The complicated neurodevelopmental disease known as autism, or autism spectrum disorder, is often identified in a child's first three years of life. Cobalamin, another name for vitamin B12, is a water-soluble vitamin that is necessary for several bodily physiological functions. Adenosylcobalamin and methylcobalamin are two coenzyme forms of vitamin B12 that are involved in the metabolism of propionate, amino acids, and single-carbon units. The study aims to investigate whether serum Vitamin B12 , Vitamin 9 and zinc levels are associated with ASD and compare it with the control group in Kirkuk City. Materials and Methods: From November 2024 to February 2025, a case-control research was conducted at the Pediatrics Hospital and two children's autism centers in Kirkuk City, Iraq: the Al-Irada Center for Autism and the Al-Tammauz Center for Autism. Kirkuk City, in northern Iraq, around 238 kilometers north of the capital, Baghdad, is where the study was carried out. Results: The city is well-known for both its substantial economic significance and its diversified population. There are 56 patients with ASD in total. There were fifteen girls and forty-one males. They were between the ages of three and twelve. There were thirty-two healthy subjects in the control group of the current investigation. Nine of them were female, while twenty-three were male. They were between the ages of three and twelve. Provides the research participants' family history and demographic details. The median age (IQR) of the 88 participants was 6 years (4–8). The ASD group had a lower median age (5.00 years [IQR: 4.00, 8.00] vs. 7.00 years [IQR: 4.75, 9.50]; p = 0.058) than the control group. The median Zinc (Mg/dl) was significantly higher in the control group compared to the ASD group (106.35 (76.25, 133.60) Mg/dl vs. 76.60 (64.65, 96.65) Mg/dl; p = 0.004).

Background/Objectives: Recessive dystrophic epidermolysis bullosa (RDEB) is a severe congenital genodermatosis characterized by skin and mucosa fragility, chronic inflammation, recurrent infections and high nutritional demands due to increased metabolism and epithelial barrier-related losses, placing patients at risk of zinc deficiency. We aimed to investigate the clinical relevance and biochemical determinants of zinc deficiency as a potentially modifiable contributor to disease burden in RDEB. Methods: In this cross-sectional study (n = 84), serum zinc levels were analyzed in association with sex, age, disease severity, percentage of body surface area (BSA) affected, inflammatory markers, infection burden, and common clinical complications including anemia and growth impairment. Results: Zinc deficiency, defined as levels below 670 µg/L, was identified in 35% of patients and became more frequent after age 5 and during adulthood, particularly among those with more severe disease. Deficiency was strongly associated with anemia, inflammation, infection burden, growth impairment, and extensive skin involvement. A revised cutoff of 780 µg/L is proposed, showing improved diagnostic performance for identifying patients at risk of systemic complications, and offering a more suitable threshold for starting preventive supplementation. Multivariate logistic modeling confirmed that low serum zinc independently predicted anemia risk, alongside transferrin saturation and C- reactive protein levels. Serum albumin was identified as the strongest determinant of zinc levels, partially mediating the effects of inflammation and skin involvement. Conclusions: These findings identify serum zinc as a clinically relevant marker of nutritional status and complication burden in RDEB. While no causal or therapeutic effects can be inferred from this cross-sectional study, the strong and biologically plausible associations observed suggest a rationale for systematic monitoring and correction of zinc deficiency as part of comprehensive supportive care, and warrant prospective studies to assess clinical benefit.

Zinc plays a critical role in thyroid hormone metabolism and antioxidant defense, yet its relationship with thyroid cancer remains unclear due to limited and inconsistent evidence from predominantly cross-sectional studies. We conducted a large-scale retrospective cohort study using the TriNetX Research Network to examine the longitudinal association between zinc deficiency (ZD) and thyroid cancer risk over ten years. Among 96,497 propensity score-matched pairs of adults who underwent serum zinc measurements between January 2010 and December 2023, we classified patients as zinc-deficient (serum zinc below 70 μg/dL) or having normal zinc status (70–120 μg/dL), controlling for demographics, comorbidities, preexisting thyroid disorders, and laboratory parameters. While the overall cohort showed no significant association between ZD and thyroid cancer at 5 years (hazard ratio [HR]: 1.13, 95% confidence interval (CI): 0.93–1.37) or 10 years (HR: 1.12, 95% CI: 0.93–1.34), sex-stratified analyses revealed that women with ZD demonstrated significantly increased thyroid cancer risk at both 5 years (HR: 1.37, 95% CI: 1.09–1.72) and 10 years (HR: 1.38, 95% CI: 1.12–1.71), while men showed no association. These findings suggest that ZD may represent a sex-specific modifiable risk factor for thyroid cancer in women, warranting further mechanistic investigation.

Evaluate associations between serum copper (Cu), rubidium (Rb), selenium (Se), strontium (Sr), and zinc (Zn) and psychophysical health in adults from Italy's Sarno River Basin within the 2025PREVES-STOP program. Adults aged 30-65 completed validated questionnaires plus clinical evaluation and blood sampling. Elements were quantified by collision/reaction-cell inductively coupled plasma mass spectrometry (ICP-MS). Associations were evaluated using Spearman and partial Spearman correlations. Significant associations included Zn and Rb associated with lower odds (odds ratio, OR) of severe fatigue- Recognizing and Estimating Signs of Tiredness (REST): Zn OR=0.38, 95 % confidence interval (CI) 0.21-0.68, q=0.02; Rb OR=0.33, 95 % CI 0.15-0.71, q=0.03-while Sr was associated with higher well-being-the World Health Organization-5 Well-Being Index (WHO-5) OR=1.36, 95 % CI 1.12-1.65, q=0.02. Findings support broader trace-element panels to inform psychophysical and cardiometabolic risk beyond classical toxic metals, complementing prior PREVES-STOP evidence on lead (Pb) and cadmium (Cd). Further investigation is warranted.

We present ZnPPA@Tz-BSA, a complex of tetrazine (Tz)-modified bovine serum albumin (Tz-BSA) and zinc porphyrin (ZnPPA), designed as a tumor-pretargeting photosensitizer. ZnPPA@Tz-BSA shows enhanced water solubility and improved reactive oxygen species (ROS) generation compared to ZnPPA alone. We demonstrate that ZnPPA@Tz-BSA can efficiently work with P-TCO through a sequential "two-step" process involving enzymatic self-immobilization labeling followed by a bioorthogonal reaction process. This strategy enables effective tumor-specific enrichment of ZnPPA@Tz-BSA, facilitating pre-targeted photodynamic therapy (PDT) of tumors in vivo.

Background: People of Asian, African, and Latino ancestry are commonly disproportionately affected by the skin disorder melasma. Melasma is characterised by a darkening of sun-exposed facial skin, most noticeably the cheeks, forehead, and nose areas. It was hypothesised that UV light encourages keratinocytes to produce more plasmin activity. The peak age for onset is estimated to be between 30 and 44 years. While women are disproportionately affected by melasma, men are not immune. Fitzpatrick skin phototypes III- IV have been found to be the most common in Melasma patients. Aims & Objective: To access is there any relation between melasma and serum zinc levels. Figuring out the average blood zinc levels in melasma patients. Are there any link between low zinc levels in the blood and melasma. Materials and Method: An observational case-control study was conducted. A sample size of 132 patients having complaints of melasma and other skin diseases as control were selected. Patients were enrolled at AVBRH sawangi dermatology outpatient department wardha, India. Following patient consent, blood samples were collected and sent to the laboratory for further analysis. This is done to compare serum zinc levels between melasma and other skin disease patients in adulthood. Results: The baseline characteristics have been presented for the recruited patients shows the age distribution of the study participants. With mean age of patients was 38.53yrs in cases and 35.35yrs in control group with no significant mean difference. The mean level of serum zinc in cases (78.23±27.79) was found to be significantly lower compared to controls (104.91±45.57). (p<0.01). Limitations: It was not a population-based study, rather a hospital-based study. Moreover, patient could not be followed up on long term basis. Serum Zinc Level test expense, due to which moderate number of patients can be taken up in the particular study. Small sample size of the study. Patients in whom the zinc levels were reduced, they were not managed by giving any Zinc supplements. Conclusion: Based on the findings, the study shows some substantial link between levels of serum zinc in affected patients of melasma. When compared to controls, melasma patients had lower serum zinc levels. Deficiency of zinc may influence melasma pathogenesis. The study does, however, strengthen the recommendation for testing for zinc deficiency in melasma patients. And the serum zinc levels findings should be interpreted with caution because the differences in mean scores were statistically significant.

In our study, we aimed to investigate the relationship between miRNA-21, miRNA-155, miRNA-34a, IL-6, TGF-β, and TNF-α expression levels and serum trace element levels in the development and progression of bladder cancer. RT-PCR was used to establish miRNA-21, miRNA-155, and miRNA-34a expression levels while serum IL-6, TGF-β, and TNF-α levels were determined using the ELISA and measured with an atomic absorption spectrophotometer. In the patient group, miRNA-21 and miRNA-155 expression levels were significantly higher compared with the healthy control group (p < 0.001). Furthermore, in the patient group, miRNA-34a expression was significantly lower compared with the control group (p < 0.001). IL-6, TNF-α, TGF-β, copper levels, and the copper to zinc ratio were significantly higher in the patient group (p < 0.001). Serum iron and zinc levels in the patient group were significantly lower compared with the control group (p < 0.001). There was a significant positive correlation between miRNA-155 and IL-6 and TNF-α (r = 0.279, p = 0.015*; r = 0.325**, p = 0.004). A significant positive correlation was detected between miRNA-34a and IL-6 and TGF-β (r = 0.294*, p = 0.010; r = 0.447**, p < 0.001). By evaluating these important biomarkers together, it might be possible to implement clinical applications for bladder cancer treatment and develop individual therapeutic strategies.

Background: Febrile seizures (FS) are among the most common pediatric emergencies. Zinc, a trace element crucial for neurodevelopment and inhibitory neurotransmission, has been implicated in seizure susceptibility. Zinc deficiency may predispose children to seizures during febrile illness. Data on its frequency in children with FS are limited in our local population. Methods: This cross-sectional study was conducted in the Pediatrics Department, Mardan Medical Complex, over six months. A total of 149 children (3–60 months) presenting with simple FS (generalized seizure <15 minutes, occurring once in 24 hours) were enrolled by non-probability consecutive sampling. Children with prior afebrile seizures, epilepsy, CNS infections, recent zinc therapy, electrolyte disturbances, or focal/complex seizures were excluded. Blood samples collected after initial stabilization of seizure were analyzed for serum zinc by colorimetric method within six hours of collection; zinc deficiency was defined as <70 μg/dL. Demographic, socioeconomic, and seizure-related data were recorded. Frequencies and percentages were calculated, and associations tested using chi-square with p≤0.05 as significant. Results: Mean age was 26 ± 15 months, with 60% males; mean weight was 12.0 ± 4.1 kg. Median seizure duration was 4 minutes. Zinc deficiency was detected in 80 of 149 patients (53.7%). Age, gender, weight, seizure duration, family history of FS, and residence showed no significant association with zinc status. However, zinc deficiency was significantly more frequent in children from lower socioeconomic backgrounds (p=0.03) and with less-educated parents (p=0.04). Conclusions: These findings highlight the potential role of zinc insufficiency in FS pathogenesis. Screening and nutritional interventions may be beneficial, though randomized trials are required to confirm preventive effects of supplementation.

Background and Objectives: Minor aphthous stomatitis (MAS) and ulcerative oral lichen planus (OLP) are chronic oral conditions with recurrent painful ulceration that significantly affects patients' quality of life. Despite extensive research, the precise etiopathogenesis of these conditions remains incompletely understood. Recent studies have found that a lack of micronutrients and key hematinics, such as zinc, vitamin B12, ferritin, and folate, may be associated with the start, severity, and recurrence of MAS and OLP. This study aimed to assess the association between these deficiencies and the occurrence of MAS and OLP compared with healthy controls. Materials and Method: A cross-sectional, case-control study was conducted at Hawler Medical University/College of Dentistry in Erbil City, Iraq. From November 2024 to June 2025, a total of 160 participants were included: 40 patients with MAS, 40 with OLP, and 80 age- and gender-matched healthy controls. Serum levels of zinc, vitamin B12, ferritin, and folate were measured alongside hematologic indices (Hb, HCT, MCV). Data were analyzed using appropriate statistical tests. Results: Both the MAS and OLP groups had much lower levels of zinc, vitamin B12, ferritin, and folate (p<0.05). Hematologic indices (Hb, HCT, MCV) were also lower in patients but still within the low-normal range. This finding suggests that subclinical hematinic deficiencies may exist, despite the absence of overt anemia. A female predominance and middle-age distribution were noted in both patient groups. When directly comparing MAS and OLP patients, the OLP group exhibited more pronounced deficiencies across all measured micronutrient and hematinic parameters, except folate, which showed higher levels of deficiency in MAS cases. Conclusion: Subclinical micronutrient deficiencies may play a role in the pathogenesis of MAS and OLP. Routine nutritional assessment of zinc and key hematinics may improve diagnosis and management strategies for these chronic oral conditions. Keywords: Hematinic indices, Minor aphthous ulcer, Nutritional deficiency, Oral lichen planus

Background: Zinc is essential for maintaining immune health, and its deficiency is prevalent in older populations, contributing to weakened defenses against infections. Prior research indicates that targeted zinc intake can help normalize levels and support T-lymphocyte activity in those with suboptimal status. Objective: We evaluated whether a 3-month course of 30 mg/day zinc supplementation could elevate serum zinc in adults over 65 years with initial levels below 70 μg/dL and explored its potential to enhance T-cell responses. Methods: This pilot trial randomized 30 participants to receive either 30 mg/day zinc (as zinc sulfate; n=15) or a low-dose control (5 mg/day zinc; n=15). The main focus was the shift in serum zinc from baseline to 3 months, with additional assessments of T-cell proliferation and select biomarkers. Results: Serum zinc rose significantly more in the zinc group (mean change: +18.1 μg/dL) than the control (±2.3 μg/dL; adjusted β=20.91 ± 2.35 μg/dL, P<0.001). Proliferation in response to anti-CD3/CD28 and phytohemagglutinin also improved (β=8.73 ± 3.15 ×1000 cpm, P=0.010; β=14.99 ± 3.70 ×1000 cpm, P<0.001, respectively), linked to higher T-cell counts (β=219.75 ± 40.67 cells/μL, P<0.001). Adjustments for T-cell numbers eliminated proliferation differences, suggesting benefits from expanded cell populations. Conclusion: Moderate-dose zinc supplementation effectively addresses marginal deficiency in older adults, with associated gains in T-cell numbers that may bolster immunity. Larger trials are needed to confirm infection-related outcomes

Introduction: This study investigated relationship between dietary habits and serum zinc levels in patients with inflammatory bowel disease (IBD) during remission and identified factors contributing to zinc deficiency. In ulcerative colitis and Crohn’s disease, low zinc levels can worsen gastrointestinal symptoms. However, current evidence regarding serum zinc levels in IBD patients remains conflicting. Methods: A retrospective cohort study was conducted at two hospitals, including 60 patients with IBD and 30 healthy controls. Participants completed a dietary questionnaire and their serum zinc levels were measured. Results: There were no significant differences in age (p=0.197) or sex (p=0.956) between groups. Employment and income levels were significantly lower in IBD patients (p<0.001 and p=0.004, respectively). Mean serum zinc levels were lower in IBD patients than controls (Crohn’s: 71.2±8.2 µg/ dL, ulcerative colitis (UC): 69.9±8.0 µg/dL vs. control: 91.9±20.7 µg/dL; p<0.001). Women had significantly lower zinc levels than men (73.6±10.8 vs. 82.1±20.9 µg/dL; p=0.016). Dietary intake of milk and legumes showed weak correlations with zinc levels (r=0.269, p=0.010; r=0.221, p=0.036). In the multivariate model, only being female (B=-11.273; p<0.001) and having IBD (Crohn’s B = -18.26; UC B = -19.298; both p<0.001) remained significant predictors of lower zinc levels. Conclusion: Female sex and the presence of IBD were associated with lower serum zinc levels. Dietary intake did not significantly influence zinc levels. These findings suggest that monitoring zinc levels in IBD patients, particularly women, may be crucial for disease management.

Patients with chronic liver disease (CLD) often experience hypozincemia. The clinical factors associated with hypozincemia have not been established. We investigated clinical factors that may be useful to predict hypozincemia in patients with CLD. The serum zinc levels CLD patients were measured; Study 1 investigated the predictive factors of hypozincemia, and Study 2 was performed to validate the factors identified in Study 1. Study 1 included 197 participants, of whom 28 and 106 had serum zinc levels <60 µg/dL and <80 µg/dL, respectively. A multivariate analysis revealed that serum zinc levels <60 µg/dL or <80 µg/dL were associated with the albumin–bilirubin (ALBI) score and serum albumin level. A receiver operating characteristic curve analysis revealed that the ALBI score ≥ −1.83 and the serum albumin level ≤3.3 g/dL were the cut-off values for a serum zinc level <60 µg/dL, whereas the ALBI score ≥ −2.44 and the serum albumin level ≤3.6 g/dL were the cut-off values for a serum zinc level <80 µg/dL. In Study 2 (n = 177), the diagnostic accuracy rates for serum zinc <60 µg/dL were 81.9% for the ALBI score and 75.1% for the serum albumin level, and those for serum zinc <80 µg/dL were 70.1% for both parameters. Together these findings indicate that the ALBI score may serve as a predictive factor of hypozincemia in CLD patients.

This study aimed to determine the serum copper and zinc levels in healthy and footrot-affected sheep in the Şanlıurfa region and investigate the relationship between these parameters and the presence of the disease. Footrot is an infectious foot disease that develops in the interdigital region of the foot and affects the skin and corium ungulae. It is characterized by necrosis, inflammation, and contagious properties. The study material consisted of 10 Akkaraman and 10 Awassi sheep clinically diagnosed with footrot (footrot group), as well as an equal number of clinically healthy animals from the same breeds, which served as the control group. Serum copper and zinc levels were measured and recorded from blood samples collected from all sheep. When the data were analyzed independently of breed, serum copper and zinc levels were significantly lower in the footrot group compared to the control group (P0.05). When all variables were evaluated, serum copper and zinc levels in footrot-affected Awassi and Akkaraman sheep were significantly lower than in healthy individuals (P

Abstract. This study provides an integrated evaluation of psychosomatic characteristics and microelement status in pediatric patients with atopic dermatitis (AD), emphasizing the diagnostic relevance of anxiety indicators alongside zinc and magnesium levels. Situational and personal anxiety were assessed using the Spielberger–Hanin scale, while disease severity was quantified with the SCORAD index. Serum zinc and magnesium concentrations were analyzed to determine microelement balance. The majority of children exhibited increased anxiety levels that were positively associated with the extent of dermatological involvement, as well as deficiencies of zinc and magnesium linked to intensified inflammatory activity and diminished stress tolerance. A combined analysis of psychoemotional and metabolic parameters enhances diagnostic precision and supports a more personalized and effective strategy for the clinical management of children with AD.

This study aimed to investigate the association between serum zinc levels and bone mineral density (BMD) in a nationally representative sample of US adults, using National Health and Nutrition Examination Survey 2011–2016 data. We sought to determine whether serum zinc is independently correlated with BMD. A cross-sectional analysis was conducted including adults aged 20 years and older from National Health and Nutrition Examination Survey 2011–2016 cycles. Serum zinc concentrations were measured by inductively coupled plasma dynamic reaction cell mass spectrometry, and BMD was assessed by dual-energy x-ray absorptiometry. Multivariable linear regression models adjusted for demographic, socioeconomic, lifestyle, and clinical covariates were used to examine the relationship between serum zinc and BMD. Nonlinear associations and threshold effects were evaluated using smooth curve fitting. A total of 2515 participants were included. Higher serum zinc quartiles were associated with progressively higher BMD (P for trend <.001). In the fully adjusted model, serum zinc was positively associated with BMD (β = 0.002, 95% CI: 0.000–0.004, P = .016). Participants in the highest serum zinc quartile (>13.91 μmol/L) had significantly greater BMD than those in the lowest quartile (6.67–10.88 μmol/L; β = 0.024, 95% CI: 0.012–0.036, P < .001). Threshold analysis revealed a nonlinear relationship, with a stronger positive association above approximately 13.9 μmol/L serum zinc. This nationally representative study provides evidence that higher serum zinc levels are independently associated with greater BMD in US adults. The observed dose–response and threshold effects highlight the potential importance of maintaining adequate zinc status for bone health and osteoporosis prevention. Further prospective studies are warranted to confirm these findings and investigate the effects of zinc supplementation.

Acrodermatitis enteropathica (AE) is a rare disorder of zinc deficiency which may be hereditary or acquired. Hereditary AE is an autosomal recessive disorder caused by defects in the zinc transporter gene SLC39A4, resulting in impaired intestinal absorption of zinc. Acquired AE arises secondary to reduced intake, increased demand, or malabsorption. Zinc, an essential micronutrient plays a key role in immune status, wound repair, gastrointestinal and metabolic function. AE is characterised by diarrhoea, recurrent infections, growth delay and skin manifestations including periorificial and acrodermatitis. We report six cases of AE seen in a tertiary centre. The mean age at presentation was 8 months (5-13 months). All patients presented with a characteristic well-demarcated crusted orofacial erythematous rash together with persistent erosive symmetrical anogenital involvement. One patient had an identified defect in the zinc transporter gene. Four patients (66%) patients were exclusively breast fed and three (50%) were born prematurely. The mean age of presentation among breastfed infants was earlier, at 3.25 months (range: 3-5 months). Low serum zinc levels were documented in 66% of cases. All patients were treated with zinc supplementation and showed rapid clinical improvement following initiation of therapy. This series highlights risk factors for developing acquired AE, including prematurity and exclusive breastfeeding. Breast milk is highest in zinc in the first 1-2 months after which zinc content declines 1, corresponding with the typical age of presentation in breastfed infants. Diagnoses is primality based upon the dermatological presentation demonstrating the importance of clinician familiarity of the presenting -features.

A Comparative Study between Laparoscopic Sleeve Gastrectomy and One Anastomosis Gastric Bypass on Serum Zinc Levels.

Preeclampsia (PE) is a multifactorial pregnancy disorder marked by hypertension and organ dysfunction. Emerging evidence suggests miRNAs, as epigenetic regulators, play a critical role. Since miR-17-3p is implicated in oxidative stress and vascular function, and considering the known roles of trace elements in redox homeostasis, we hypothesized that their interplay contributes to PE pathogenesis. This study examines the relationship between miRNA-17-3p expression, oxidative stress markers, and trace element levels (zinc and copper) in PE patients. A case-control study included 140 pregnant women (70 with PE and 70 controls). Placental tissue and serum samples were analyzed for miRNA-17-3p expression, oxidative stress markers [superoxide dismutase (SOD), total antioxidant capacity (TAC), total oxidative status (TOS)], and trace element levels. Statistical analyses explored associations among these variables. miRNA-17-3p expression was significantly elevated in the placental tissue and serum of PE patients (P < 0.001). Serum zinc levels significantly decreased, while copper levels increased in the patient group (P < 0.05). SOD activity and TAC levels were reduced, whereas TOS was elevated in PE patients (P < 0.05). miRNA-17-3p is significantly dysregulated in PE, accompanied by increased oxidative stress and disrupted trace element balance. These findings provide insights into potential mechanisms and novel therapeutic targets for managing PE.

Objective: The aim of the study is to assess zinc levels in women with acne vulgaris and their relationship to the severity of the clinical acne lesions and the facial sites involvement with acne vulgaris Methods: This study included 100 women aged 19-25 years. Fifty of them had acne, and 50 did not, serving as a control group. Serum zinc levels were measured using the Bromo-PAP-5 colorimetric method. Acne severity was assessed, and the most affected areas on the face were identified. Result: The results showed a significant and highly significant decrease in zinc levels in women with acne (63.6 ± 16.7 μg/dL) compared to healthy women (control group), whose levels were (91.9 ± 8.8 μg/dL). Fifty percent of the patients had moderate acne. The most commonly affected areas on the face were the cheeks (60%), the forehead (30%), and the chin (10%). A significant correlation was found between acne severity and serum zinc levels. Conclusion: The study suggests a link between low zinc levels and increased acne in some women. Therefore, zinc can be considered an important element for skin health and may be used as an adjunctive treatment for acne.

Patient: Female, 8-year-oldFinal Diagnosis: Acrodermatitis enteropathicaSymptoms: Chronic dermatitis since infancy, featuring perioral and acral skin lesions, alopecia, and a recent diffuse vesiculobullous rash consistent with Kaposi’s varicelliform eruptionClinical Procedure: —Specialty: DermatologyObjective: Unusual clinical courseBackgroundAcrodermatitis enteropathica (AE) is a rare autosomal recessive disorder caused by solute carrier family 39 member 4 (SLC39A4) gene variants that impair zinc absorption. Although typically associated with bacterial or fungal superinfection, its concurrence with Kaposi’s varicelliform eruption (KVE) is exceptionally rare – only 1 case was previously reported. This report describes a case of KVE complicating AE in a patient with novel compound heterozygous SLC39A4 variants, highlighting the immunovirological implications of zinc deficiency.Case ReportAn 8-year-old girl who had chronic dermatitis since infancy presented with a diffuse vesiculobullous rash. Physical examination revealed perioral and acral dermatitis, alopecia, and crusted vesicles consistent with KVE. Laboratory testing showed normal serum zinc levels (76.13 μg/dL) but reduced alkaline phosphatase (32 U/L). Genetic analysis identified compound heterozygous SLC39A4 variants: a maternal frameshift variant (c.522_523dup) and 3 paternal variants (c.925T>C, c.1782C>T, and c.1843C>T). The patient received oral zinc gluconate and topical crisaborole ointment, achieving complete resolution within 2 weeks.ConclusionsThis case demonstrates that AE may present with normal zinc concentrations, underscoring the diagnostic value of alkaline phosphatase. Genetic confirmation remains essential in atypical presentations. These novel variants broaden the mutational spectrum of SLC39A4 and emphasize the importance of early zinc supplementation and antiviral prophylaxis in patients with AE who display KVE risk.