If untreated, cutaneous and lid lesions may become secondarily infected with S aureus and C albicans. Infants also may experience withdrawal, photophobia, and loss of appetite. Further progression and even death from secondary infection may occur if AE is left untreated. Additional family members at risk also may be discovered. With early diagnosis and zinc supplementation, the prognosis is good.
Ophthalmic complications are far less severe when the systemic disease is treated.
Advanced cases may have severe ophthalmic complications. Follow-up care with the appropriate specialists, and clear instructions for zinc supplementation are essential. Delayed diagnosis presents the most urgent cause for litigation risk, which usually lies within the realm of the pediatrician. Dermatologic consultation may be key, while the ophthalmologist rarely is called upon to finalize the diagnosis. AE may only be diagnosed accurately through dietary zinc restriction and withdrawal, since a genetically based test currently is unavailable.