Marasmus and kwashiorkor

Feature

Marasmus

Kwashiorkor

Age of onset

<1 year old

1-5 year old

Cause

Calorie deficiency

Protein deficiency

Appearance

Alert child

Lithargic child

Weight

Severe weight loss

Moderate weight loss or

maintained weight with edema

Edema

Not present

Present (especially in

legs and abdomen)

Fatty liver

(Hepatomegaly)

Rare

Common

Wasting

Visible

Masked due to edema

Appetite

Good

Poor / Absent

Facial

appearance

Monkey / Old man / Simian

facies (Buccal fat loss)

Moon face / Sugar

baby appearance

Skin changes

Baggy pants appearance

(loose skin of the buttocks

hanging down)

Flaky paint dermatosis

Hair changes

No characteristic changes

Flag sign / Black & white hair

(alternating bands

of hypopigmentation)

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