Kwarshiorkor

  • Insufficient protein intake only (adequate calories)
  • Risk factors
    • Protein-losing enteropathies, extensive GI surgery, HIV
  • Mechanism
    • Lack of protein → hypoalbuminemia → edema (can mask wasting of fatty tissue - moon face)
  • Clinical presentation
    • Dyschromia, pallor, superficial desquamation (enamel paint spots)
    • Erythema, thinning, purpura (vessel fragility, loss of dermal connective tissue)
    • Hair is sparse, dry, brittle, light/dark bands
      • ”flag sign” - alternation of light and darker areas, resulting from periods of malnutrion and normal nutrition
    • Soft thin nails, cheilitis