Dermatological Manifestation in Malnourished Children under 5 Years of Age in a Tertiary Care Hospital
Abstract
Background: The replenishment of macronutrients and micronutrients is essential for normal function of cutaneous tissues, making cutaneous manifestations a good indicator of nutritional status. Objective: To evaluate dermatological manifestation in malnourished children under 5 years of age presenting in pediatric outpatient clinic in a tertiary care hospital. Materials and Methods: This cross-sectional study was performed in Pediatric outpatient clinics at Liaquat National Hospital during 1st August 2024 to 1st August 2025 bearing IRB no App#1067-2024-LNH-ERC, dated: 24th July 2024. Children under five-years of age having malnutrition were included. Assessment of malnutrition was done using anthropometric measurements (weight and length/height) to calculate Z-scores using the WHO reference standards. A dermatological examination was carried out by a consultant dermatologist to evaluate skin manifestations. Recorded data included patients' age, gender, WHO-z scores, term status, feeding type, immunization status, monthly income, maternal education and dermatological complaints. Result: A total of 196 patients were studied with an average age of 27.3 ± 11.6 months. The acute malnutrition based on WHZ-Score demonstrated that 54.1% children having moderate acute malnutrition and 45.9% children having severe acute malnutrition. The most frequent manifestation was angular cheilitis (89.8%) followed by lusterless hair (84.7%) and xeroderma (82.1%), pigmentary change (66.8%) of patients, lost subcutaneous fat 63.8%), and excessive lanugo lashes (25.5%), ichthyosis skin changes and lichenoid skin changes (9.2%). Conclusion: This study shows that malnourished children exhibit cutaneous and adnexal related disorders. Regardless of clinical spectrum, these dermatological manifestations frequently seen in malnourished children with angular cheilitis, lusterless hairs and xeroderma being the most common features. Keyword: Severe Acute Malnutrition, Child Nutrition Disorders, Skin Diseases, Cheilitis, Child, Preschool, Xerodermia, Ichthyotic, Ichenoid.