In zinc deficiency disorders the serum zinc concentration is low and the activity of alkaline phosphatase in serum is declining. The clinical picture includes a poor general condition and a characteristic dermatitis on hands, feet, in the face, and the anogenital region. In acute zinc deficiency, the eruption is vesico-bullous, in the chronic state parakeratotic psoriasiform. Widespread exzéme craquelée is an additional feature of the clinical picture, as seen in cirrhotics with acquired zinc deficiency. Alopecia, Beau lines on the nails, and hair changes may develop. In severe cases zinc therapy usually in the form of zinc sulphate may be administered i.v. (10-20 mg Zn daily). Oral zinc therapy is initially given in high doses (145-150 mg Zn daily). Long-term high zinc doses may interfere with copper metabolism and are only indicated for acrodermatitis enteropathica.