Zinc deficiency dermatitis is a recognized complication of prolonged total parenteral nutrition (TPN) in adults and children. Ten cases of a characteristic dermatosis developing in premature infants with hypozincemia while on long-term TPN are described. The infants presented a defined group of premature neonates who were born between 25 and 28 weeks' gestation with birth weights of less than 1,200 gm and who had received continuous prolonged TPN. The characteristic skin changes appeared on an average of 91 days after birth, with prominent and early involvement of the neck fold crease. Lesions also occurred on the cheeks, buttocks, and genitalia, but spared the extremities. In seven of the ten cases, the skin changes and low serum zinc levels developed 1 to 5 days after an episode of bacterial sepsis or signs of physiologic stress.