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2023, Number 4

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Rev Fac Med UNAM 2023; 66 (4)

Dermatological Manifestations in an Infant with Kwashiorkor Syndrome: Keys for Diagnosis and Timely Treatment

Hernández LKA, García RMT, Olvera SA, Revilla ENF
Full text How to cite this article

Language: Spanish
References: 16
Page: 20-25
PDF size: 210.05 Kb.


Key words:

Malnutrition, dermatoses, edema, feeding, desquamation.

ABSTRACT

Kwashiorkor syndrome is characterized by protein malnutrition and edema, risk factors are recent weaning, infections, and diets based on corn and rice.
This malnutrition can lead to skin manifestations such as thin, dry skin, hyperpigmentation, confluent areas of scaling, dry, hypopigmented, and detachable hair, as well as erosive dermatitis, predominantly in skin folds.
The diagnosis is based on a nutritional evaluation exam, physical examination and laboratory finding, the treatment is based on early nutritional rehabilitation.
Clinical case: 8-month-old female infant who attended the Instituto Nacional de Pediatría, presenting a scaling dermatosis of 1 month’s evolution that was treated with topical ketoconazole. The mother reported exclusive feeding with corn gruel due to the diagnosis of “lactose allergy” and commented not enough resources to buy hydrolyzed formula.
The patient presented a disseminated dermatosis to all body segments, characterized by well-defined, irregularly shaped, hyperpigmented plaques with scaling in thick sheets in the perioral region and extremities, as well as areas of eroded skin and paleness and edema of extremities. Laboratory tests were taken, where anemia (Hb 11.2 g/dl) and hypoalbuminemia (3.3 g/dl) were documented, the diagnosis of kwashiorkor syndrome was integrated.
The clinical and laboratory findings were reported to the Gastroenterology and Nutrition service, who performed a nutritional assessment, and began nutritional treatment, emollients and general skin care were documented; twenty days later, the dermatosis and edema had subsided.


REFERENCES

  1. Kulkarni B, Mamidi RS. Nutrition rehabilitation of childrenwith severe acute malnutrition: Revisiting studiesundertaken by the National Institute of Nutrition. TheIndian Journal of Medical Research. 2019;150(2):139-152.

  2. Ayala Germán AG, Loredo Mayer A, Zárate Mondragón F,Toro Monjaráz EM, Mon- tijo Barrios E, Cadena León JF,Ignorosa Arellano KR, Cervantes Bustamante R, RamírezMayans JA. Manejo hospitalario de desnutrición severa enpediatría. Acta Pediatr Méx. 2022;43(3):193-99.

  3. Balasubramaniam S, Christodoulou J, Rahman S. Disordersof riboflavin metabolism. J Inherit Metab Dis. 2019Jul;42(4):608-619.

  4. Shamah-Levy T, Romero-Martínez M, Barrientos-Gutiérrez T, Cuevas-Nasu L, Bautista-Arredondo S etal. Encuesta Nacional de Salud y Nutrición 2020 sobreCOVID-19. Resultados nacionales. Cuernavaca, México:Instituto Nacional de Salud Pública; 2021.

  5. Batis C, Denova-Gutiérrez E, Estrada-Velasco BI, RiveraJ. Malnutrition prevalence among children and womenof reproductive age in Mexico by wealth, education level,urban/rural area and indigenous ethnicity. Public HealthNutr. 2020 Aug;23(S1):s77-s88.

  6. Muñoz R. Desnutrición Severa Tipo Kwashiorkor. RevistaGastrohnup. 2013;15(1):20-26.

  7. De La Cruz V. Anemia y deficiencia de micronutrimentosen niñas, niños, adolescentes y mujeres en edad reproductiva.Instituto Nacional De Salud Pública; 2021.

  8. Sandoval Serrano L, Velandia Siabato A, Gómez LópezMT, Torres Medina RY. Manifestaciones dermatológicasen Kwashiorkor: reporte de caso y revisión de la literatura.Rev Argent Dermatol. 2019 Mar;100(1):67-77.

  9. Rytter Mj, Michaelsen Kf, Friis H, Christensen Vb. Et.Al. Acute Malnutrition. En Children. [Internet] UgeskrLaeger; 2017.

  10. Thi-Phuong-Thao Pham, et al. Difference between kwashiorkorand marasmus: Comparative meta-analysis ofpathogenic characteristics and implications for treatment.Microbial pathogenesis. 2021;150.

  11. Benjamin O, Lappin SL. Kwashiorkor. En: StatPearls.Treasure Island (FL): StatPearls; 2022.

  12. Vijayasankar P, Karthikeyan K. Flaky Paint Dermatosis inKwashiorkor. Am J Trop Med Hyg. 2021 Oct 4;106(1):3.

  13. Dipasquale V, Cucinotta U, Romano C. Acute Malnutritionin Children: Pathophysiology, Clinical Effects andTreatment. Nutrients. 2020 Aug 12;12(8):2413.

  14. Heilskov S, Rytter MJ, Vestergaard C, Briend A, BabirekereE, Deleuran MS. Dermatosis in children with oedematousmalnutrition (Kwashiorkor): a review of the literature.J Eur Acad Dermatol Venereol. 2014 Aug;28(8):995-1001.

  15. Grover Z, Ee LC. Protein energy malnutrition. PediatrClin North Am. 2009 Oct;56(5):1055-68.

  16. Pham TP, Alou MT, Golden MH, Million M, RaoultD. Difference between kwashiorkor and marasmus:Comparative meta-analysis of pathogenic characteristicsand implications for treatment. Microb Pathog. 2021Jan;150:104702.




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Rev Fac Med UNAM . 2023;66