Spectrum of malnutrition associated skin, hair and eye changes among malnourished children aged 0-59 months coming to The Indus Hospital, Karachi, Pakistan

Abstract

Background: Skin, hair, and ocular manifestations are common but often overlooked indicators of malnutrition. Early recognition facilitates timely nutritional intervention, especially in resource-limited settings.

Objectives: To determine the pattern and frequency of skin, hair and ocular changes among malnourished children under five years of age in a tertiary care hospital.

Method: This cross-sectional study was conducted at the paediatric ward and OPD of Indus Hospital and Health Network, Karachi from October 2024 to March 2025. In this study, 120 children under 5 years of age participated. Malnutrition screening was done through weight-for-height Z-score and mid-upper arm circumference. Detailed examination was performed to see the effects of malnutrition on skin, hair and eyes. Data were collected using a pre-designed questionnaire and analysed using SPSS version 26 with p <0.05 was considered statistically significant.

Results: The median age was 20 months. There were 47 (39.2%) males. Skin changes were observed in 102 children (85.0%).  The common presentations were xeroderma (38.2%), hyperpigmentation (29.4%) and hypopigmentation (25.4%). Hair changes, noted in 101 children (84.1%), were sparse (59.4%), dry lusterless(52.4%) and easily pluck-able hair (7.9%). Ocular involvement was rare, affecting only 3 children (2.5%).

Conclusion: Skin and hair manifestations were highly prevalent, whereas ocular involvement was uncommon. Routine examination of the skin, hair, and eyes should be incorporated into the assessment of malnourished children to facilitate early recognition of nutritional deficiencies and timely intervention.