Defining and assessing skin changes in severe acute malnutrition (SAM)

Abstract

Specific skin changes in severe acute malnutrition have been known since the earliest publication on the subject in 1933. They vary from mild dryness or pigmentary changes to severe and widespread erosions. A common standardized way to document the skin changes observed in severe acute malnutrition is still under development. Currently five specific skin changes, characteristic to severe acute malnutrition, have been identified in African children. There is no knowledge of the global prevalence, but most reports on severe skin affections are from sub-Saharan countries. The etiology is still unknown and the recommendations on treatment are mostly based on expert opinion. Skin changes in severe acute malnutrition have proven to be a prognostic marker for the risk of death. The mortality rate for patients treated for severe acute malnutrition is persistently high and thus the skin is a target for new treatment approaches. The skin is easily accessible for administration of treatment and assessment and is potentially a good additional target to the existing treatment protocols.