This autosomal recessive disorder presents with a striking and unmistakable skin manifestation when the infant is weaned or placed on mixed feeding. It first appear in the perineal skin and is often confused with the napkin rash. Later crusting and scaling appear round the natural orifices, including the eyes and ears. The psoriasiform eruption appears over projecting surfaces. The nails are shed from all the digits, which become the site of paronychia. This disorder probably due to an inherited intestinal enzyme defect, which leads to the sequestration of zinc. supplements 150mg of daily zinc sulphate being optimal.