Manifestaciones dermatológicas en una lactante con síndrome de kwashiorkor: Claves para el diagnóstico y tratamiento oportuno

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 months of 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. Keywords: Malnutrition; dermatoses; edema; feeding; desquamation.