- Skin
- In kwashiorkor, there may be areas of hypo- or hyperpigmentation, hyperkeratosis, shedding of the skin, cracks and fissures, and/or extensive desquamation; in marasmus, skin is often thin and flaccid.
- Evidence of measles suggests higher risk for poor outcome
- Bullous pustular dermatitis (moist erythematous plaques) around mouth and anus suggests zinc deficiency
- Hair
- Lightly colored to shades of brown/red; lack of luster; sparsely distributed to alopecia; thin and easily pluckable; "flag sign"
- Mouth
- Ulcers, angular stomatitis, oral thrush (thrush suggests possible immunosuppression)
- Central nervous system
- Apathetic face and irritability
- Muscles
- Signs of severe wasting include "old man" face, emaciated limbs, increased axillary skin folds, buttock wasting, visible ribs and scapula, overhanging skin, and flabby muscles
- In patients with kwashiorkor, muscle wasting may be masked by edema but is often apparent as loose inguinal skin folds
- Other
- Pallor
- Localizing signs of infection (ear, throat, skin, chest)
- Abdominal distention
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