A child with kwashiorkor misdiagnosed as atopic dermatitis

Although uncommon, kwashiorkor continues to occurin developed, but mainly in developing nations. It is atype of protein-calorie malnutrition that occurs in thesetting of insufficient protein intake in the presence ofsufficient caloric intake. Skin and hair changes shouldprompt a thorough dietary history and appropriatedietary intervention. We report a case of a 12-montholdgirl in Belo Horizonte, Minas Gerais, Brazil, whopresented with diffuse edema, desquamation, andirritability misdiagnosed as atopic dermatitis. Thediagnosis was consistent with kwashiorkor as a resultof severe dietary restriction. The mother had placedthe child on a severely restrictive diet, consisting onlyof potatoes, gelatin, and juice as a consequence of theinability to breastfeed. Kwashiorkor is often underdiagnosedor misdiagnosed and if unrecognizedor untreated, may be devastating. This makes itimperative that physicians consider this diagnosis,recognize potential risk factors, and be prepared toaccurately assess overall nutritional status of patients.