Protein-Energy Malnutrition Differential Diagnoses

  • Author: Noah S Scheinfeld, MD, JD, FAAD; Chief Editor: William D James, MD   more...
 
Updated: Jul 18, 2011
 
 

Differential Diagnoses

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Contributor Information and Disclosures
Author

Noah S Scheinfeld, MD, JD, FAAD  Assistant Clinical Professor, Department of Dermatology, Columbia University College of Physicians and Surgeons; Consulting Staff, Department of Dermatology, St Luke's Roosevelt Hospital Center, Beth Israel Medical Center, and New York Eye and Ear Infirmary; Private Practice

Noah S Scheinfeld, MD, JD, FAAD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Optigenex Consulting fee Independent contractor

Coauthor(s)

Anusuya Mokashi, MS, MD  Radiology Resident, Staten Island University Hospital

Disclosure: Nothing to disclose.

Andrew Lin, MD, FRCPC  Associate Professor, Department of Internal Medicine, Division of Dermatology, University of Alberta

Andrew Lin, MD, FRCPC is a member of the following medical societies: American Academy of Dermatology and Royal College of Physicians and Surgeons of Canada

Disclosure: Nothing to disclose.

Specialty Editor Board

Michelle Pelle, MD  Clinical Assistant Professor, Division of Dermatology, Department of Medicine, University of California at San Diego

Michelle Pelle, MD is a member of the following medical societies: American Academy of Dermatology, California Medical Association, Medical Dermatology Society, and Pennsylvania Medical Society

Disclosure: Nothing to disclose.

David F Butler, MD  Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic, Northside Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Jeffrey J Miller, MD  Associate Professor of Dermatology, Pennsylvania State University College of Medicine; Staff Dermatologist, Pennsylvania State Milton S Hershey Medical Center

Jeffrey J Miller, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Association of Professors of Dermatology, North American Hair Research Society, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

William D James, MD  Paul R Gross Professor of Dermatology, University of Pennsylvania School of Medicine; Vice-Chair, Program Director, Department of Dermatology, University of Pennsylvania Health System

William D James, MD is a member of the following medical societies: American Academy of Dermatology and Society for Investigative Dermatology

Disclosure: Elsevier Royalty Other

Acknowledgments

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous author, Dr. Dino Santoro, to the development and writing of this article.

References

  1. Onis M de, Monteiro C, Clugston G. The worldwide magnitude of protein-energy malnutrition: an overview from the WHO Global Database on Child Growth. Bulletin of the World Health Organization. 1993;71(6).

  2. Lin CA, Boslaugh S, Ciliberto HM, et al. A prospective assessment of food and nutrient intake in a population of Malawian children at risk for kwashiorkor. J Pediatr Gastroenterol Nutr. Apr 2007;44(4):487-93. [Medline].

  3. Tierney EP, Sage RJ, Shwayder T. Kwashiorkor from a severe dietary restriction in an 8-month infant in suburban Detroit, Michigan: case report and review of the literature. Int J Dermatol. May 2010;49(5):500-6. [Medline].

  4. World Health Organization, Dept of Nutrition for Health and Development. Nutrition for health and development: a global agenda for combating malnutrition. World Health Organization. Available at http://whqlibdoc.who.int/hq/2000/WHO_NHD_00.6.pdf.

  5. Jildeh C, Papandreou C, Abu Mourad T, et al. Assessing the Nutritional Status of Palestinian Adolescents from East Jerusalem: a School-based Study 2002-03. J Trop Pediatr. Jul 31 2010;[Medline].

  6. Jen M, Yan AC. Syndromes associated with nutritional deficiency and excess. Clin Dermatol. Nov-Dec 2010;28(6):669-85. [Medline].

  7. Lewandowski H, Breen TL, Huang EY. Kwashiorkor and an acrodermatitis enteropathica-like eruption after a distal gastric bypass surgical procedure. Endocr Pract. May-Jun 2007;13(3):277-82. [Medline].

  8. Al-Mubarak L, Al-Khenaizan S, Al Goufi T. Cutaneous presentation of kwashiorkor due to infantile Crohn's disease. Eur J Pediatr. Jan 2010;169(1):117-9. [Medline].

  9. Sander CS, Hertecant J, Abdulrazzaq YM, Berger TG. Severe exfoliative erythema of malnutrition in a child with coexisting coeliac and Hartnup's disease. Clin Exp Dermatol. Mar 2009;34(2):178-82. [Medline].

  10. Tavarela Veloso F. Review article: skin complications associated with inflammatory bowel disease. Aliment Pharmacol Ther. Oct 2004;20 Suppl 4:50-3. [Medline].

  11. Harima Y, Yamasaki T, Hamabe S, et al. Effect of a late evening snack using branched-chain amino acid-enriched nutrients in patients undergoing hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma. Hepatol Res. Jun 2010;40(6):574-84. [Medline].

  12. Demling RH. The incidence and impact of pre-existing protein energy malnutrition on outcome in the elderly burn patient population. J Burn Care Rehabil. Jan-Feb 2005;26(1):94-100. [Medline].

  13. Thavaraj V, Sesikeran B. Histopathological changes in skin of children with clinical protein energy malnutrition before and after recovery. J Trop Pediatr. Jun 1989;35(3):105-8. [Medline].

  14. McKenzie CA, Wakamatsu K, Hanchard NA, Forrester T, Ito S. Childhood malnutrition is associated with a reduction in the total melanin content of scalp hair. Br J Nutr. Jul 2007;98(1):159-64. [Medline].

  15. Chung SH, Stenvinkel P, Lindholm B, Avesani CM. Identifying and managing malnutrition stemming from different causes. Perit Dial Int. Jun 2007;27 Suppl 2:S239-44. [Medline].

  16. [Guideline] US Department of Health and Human Services, US Department of Agriculture. Dietary guidelines for Americans, 2005. National Guideline Clearinghouse. 2005.

  17. Balint JP. Physical findings in nutritional deficiencies. Pediatr Clin North Am. Feb 1998;45(1):245-60. [Medline].

  18. Beers MH, Berkow R, eds. Nutritional Disorders: Malnutrition. In: The Merck Manual. 17th ed. Merck; 1999:28-32.

  19. Caksen H, Kendirci M, Kandemir O, Patiroglu T. A case of malignant histiocytosis associated with skin involvement mimicking kwashiorkor. Pediatr Dermatol. Nov-Dec 2001;18(6):545-6. [Medline].

  20. Collins N. Protein-energy malnutrition and involuntary weight loss: nutritional and pharmacological strategies to enhance wound healing. Expert Opin Pharmacother. Jul 2003;4(7):1121-40. [Medline].

  21. Constans T, Alix E, Dardaine V. [Protein-energy malnutrition. Diagnostic methods and epidemiology]. Presse Med. Dec 16 2000;29(39):2171-6. [Medline].

  22. De Caprio C, Alfano A, Senatore I, Zarrella L, Pasanisi F, Contaldo F. Severe acute liver damage in anorexia nervosa: two case reports. Nutrition. May 2006;22(5):572-5. [Medline].

  23. Delahoussaye AR, Jorizzo JL. Cutaneous manifestations of nutritional disorders. Dermatol Clin. Jul 1989;7(3):559-70. [Medline].

  24. Glaser, KL. Pediatrics: Malnutrition. Medstudents. Available at http://www.medstudents.com.br/pedia/pedia1.htm.

  25. Golden MHN. Severe malnutrition. In: Weatherall DJ, Ledingham JGG, Warrell DA, eds. Oxford Textbook of Medicine. 3rd ed. 1996:1278-96.

  26. Goskowicz M, Eichenfield LF. Cutaneous findings of nutritional deficiencies in children. Curr Opin Pediatr. Aug 1993;5(4):441-5. [Medline].

  27. Gupta MA, Gupta AK, Haberman HF. Dermatologic signs in anorexia nervosa and bulimia nervosa. Arch Dermatol. Oct 1987;123(10):1386-90. [Medline].

  28. Gurski RR, Schirmer CC, Rosa AR, Brentano L. Nutritional assessment in patients with squamous cell carcinoma of the esophagus. Hepatogastroenterology. Nov-Dec 2003;50(54):1943-7. [Medline].

  29. Harris CL, Fraser C. Malnutrition in the institutionalized elderly: the effects on wound healing. Ostomy Wound Manage. Oct 2004;50(10):54-63. [Medline].

  30. Hendricks KM, Duggan C, Gallagher L, et al. Malnutrition in hospitalized pediatric patients. Current prevalence. Arch Pediatr Adolesc Med. Oct 1995;149(10):1118-22. [Medline].

  31. Jilcott SB, Masso KL, Ickes SB, Myhre SD, Myhre JA. Surviving but not quite thriving: anthropometric survey of children aged 6 to 59 months in a rural Western Uganda district. J Am Diet Assoc. Nov 2007;107(11):1983-8. [Medline].

  32. Kuhl J, Davis MD, Kalaaji AN, Kamath PS, Hand JL, Peine CJ. Skin signs as the presenting manifestation of severe nutritional deficiency: report of 2 cases. Arch Dermatol. May 2004;140(5):521-4. [Medline].

  33. Lyder CH. Assessing risk and preventing pressure ulcers in patients with cancer. Semin Oncol Nurs. Aug 2006;22(3):178-84. [Medline].

  34. Manguso F, D'Ambra G, Menchise A, Sollazzo R, D'Agostino L. Effects of an appropriate oral diet on the nutritional status of patients with HCV-related liver cirrhosis: a prospective study. Clin Nutr. Oct 2005;24(5):751-9. [Medline].

  35. McLaren DS. Skin in protein energy malnutrition. Arch Dermatol. Dec 1987;123(12):1674-1676a. [Medline].

  36. Miller SJ. Nutritional deficiency and the skin. J Am Acad Dermatol. Jul 1989;21(1):1-30. [Medline].

  37. Neldner KH. Nutrition, aging and the skin. Geriatrics. Feb 1984;39(2):69-82, 87-8. [Medline].

  38. Pelly TF, Santillan CF, Gilman RH, et al. Tuberculosis skin testing, anergy and protein malnutrition in Peru. Int J Tuberc Lung Dis. Sep 2005;9(9):977-84. [Medline].

  39. Prendiville JS, Manfredi LN. Skin signs of nutritional disorders. Semin Dermatol. Mar 1992;11(1):88-97. [Medline].

  40. Rabinowitz SS, Gehri M, Stettler N, Di Paolo ER. Marasmus. eMedicine from WebMD [serial online]. May 20, 2009;Available at http://emedicine.medscape.com/article/984496-overview.

  41. Roongpisuthipong C, Sobhonslidsuk A, Nantiruj K, Songchitsomboon S. Nutritional assessment in various stages of liver cirrhosis. Nutrition. Sep 2001;17(9):761-5. [Medline].

  42. Ryan AS, Goldsmith LA. Nutrition and the skin. Clin Dermatol. Jul-Aug 1996;14(4):389-406. [Medline].

  43. Schneider JB, Norman RA. Cutaneous manifestations of endocrine-metabolic disease and nutritional deficiency in the elderly. Dermatol Clin. Jan 2004;22(1):23-31, vi. [Medline].

  44. Shah S, Kannikeswaran N, Kamat D. A rash. Clin Pediatr (Phila). Sep 2007;46(7):650-4. [Medline].

  45. Shashidhar HR, Grigsby DG. Malnutrition. eMedicine from WebMD [serial online]. April 9, 2009;Available at http://emedicine.medscape.com/article/985140-overview.

  46. Soni BP, McLaren DS, Sherertz EF. Skin lesions in nutritional, metabolic and heritable disorders: cutaneous changes in nutritional disease. In: Fitzpatrick's Dermatology in General Medicine. Vol 2. 1999:1725-37.

  47. Tirmentajn-Jankovic B, Dimkovic N. [Simple methods for nutritional status assessment in patients treated with repeated hemodialysis]. Med Pregl. Sep-Oct 2004;57(9-10):439-44. [Medline].

  48. Wilmer WA, Magro CM. Calciphylaxis: emerging concepts in prevention, diagnosis, and treatment. Semin Dial. May-Jun 2002;15(3):172-86. [Medline].

 
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