Distinguishing features of marasmus versus kwashiorkor (edematous malnutrition)

	Marasmus	Kwashiorkor (edematous malnutrition)
Height and weight	Low weight for height (wasting). Low height for age (stunting), if also chronically malnourished.	Weight for age is variable. Low height for age (stunting) if also chronically malnourished.
Head	Appears large relative to body, with staring eyes.	Moon face (rounded prominence of the cheeks), with or without facial edema. May appear plump.
Extremities	Emaciated arms, thighs, and buttocks, with loose folds due to loss of subcutaneous fat.	Edema: Mild (1+) – Involves only the feet Moderate (2+) – Involves feet, legs, and upper limbs Severe (3+) – Either generalized edema or moderate plus facial edema
Behavior	Typically irritable, fretful.	Typically apathetic, listless; may be irritable when handled.
Abdomen		Distended, dilated intestinal loops; hepatomegaly.
Skin	Thin, dry skin.	Thin, dry and peeling skin, with areas of hyperkeratosis and hyperpigmentation (dermatosis of kwashiorkor).
Hair	Thin, sparse hair that is easily plucked.	Dry, dull, and hypopigmented hair that falls out or is easily plucked. Hypopigmentation may occur in stripes if malnutrition has been intermittent ("flag sign").

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