Histopathological Changes in Skin of Children with Clinical Protein Energy Malnutrition Before and After Recovery

Thavaraj, Vasantha; Sesikeran, B.

doi:10.1093/tropej/35.3.105

Cited by 16 publications

(11 citation statements)

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“…Compromise of the skin barrier is the most clinically evident defect in children with oedematous malnutrition, classically described as the 'peeling paint' dermatosis of kwashiorkor [13]. Histologically, this is characterized by atrophy and effacement of the skin layers, hyperkeratosis and a pronounced cutaneous inflammatory response [14][15][16], providing a potential portal of entry for pathogens. An extensive enteropathy has long been recognized in children with severe malnutrition, characterized by mucosal inflammatory infiltrate, villous atrophy and compromised intestinal barrier function [17].…”

Section: (A) Mucosal Barrier Dysfunctionmentioning

confidence: 99%

Malnutrition and vaccination in developing countries

Prendergast

2015

Phil. Trans. R. Soc. B

124

103

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Malnutrition contributes to an estimated 45% of deaths among children under 5 years of age in developing countries, predominantly due to infections. Malnourished children therefore stand to benefit hugely from vaccination, but malnutrition has been described as the most common immunodeficiency globally, suggesting that they may not be able to respond effectively to vaccines. The immunology of malnutrition remains poorly characterized, but is associated with impairments in mucosal barrier integrity, and innate and adaptive immune dysfunction. Despite this, the majority of malnourished children can mount a protective immune response following vaccination, although the timing, quality and duration of responses may be impaired. This paper reviews the evidence for vaccine immunogenicity in malnourished children, discusses the importance of vaccination in prevention of malnutrition and highlights evidence gaps in our current knowledge.

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Section: (A) Mucosal Barrier Dysfunctionmentioning

confidence: 99%

Malnutrition and vaccination in developing countries

Prendergast

2015

Phil. Trans. R. Soc. B

124

103

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“…Thavaraj and Sesikeran [3] reported dermal edema with a reduction in collagen and increased melanin in the basal layer in a study of the histopathological changes in children with PEM. Vasantha [19] demonstrated decreased soluble collagen and retardation of collagen maturation in rats exposed to protein and caloric deficiency.…”

Section: Resultsmentioning

confidence: 99%

“…Our knowledge about the role of nutrition in the development and maintenance of healthy skin stems largely from observations of clinical skin changes accompanying undernutrition such as scaly dermatosis and skin lesions exhibiting hyperkeratosis [1-3]. Little is known about the impact of nutrition on the maturation of skin structure and function from birth and through the first years of life.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Skin Structural and Functional Parameters in Well-Nourished and Moderately Undernourished Infants

Hughes-Formella¹,

Wunderlich²,

Williams³

et al. 2019

Skin Pharmacol Physiol

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Background: Little is known about the impact of nutrition on the development of skin structure and function in infants. Methods: We investigated epidermal, dermal, and subcutis parameters of aged-matched well-nourished and moderately undernourished infants in this single-center, cross-sectional, noninterventional study using noninvasive methods (skin caliper, 20-MHz sonography, transepidermal water loss, skin pH, and corneometry). Plasma fatty acids were determined as an indicator of nutritional differences. 310 infants from different age groups, i.e., 1 week, 4 weeks, and 6, 9, 12, 24, and 36 months were included. Approximately half of each age group was well-nourished (WHO reference values weight-for-height/length Zscore: –0.75 ≤ Z ≤ 0.75) and the other half was moderately undernourished (–3 ≤ Z < –2). Results: Structural maturational differences in the deeper dermis and subcutis regions of the skin and subtle functional changes in the epidermis were observed in moderately undernourished infants without notable clinical symptoms. Reduced skin barrier function or skin hydration were not observed in the undernourished infants, and skin pH shifted to more acidic values in this group. Conclusion: These findings reveal a greater impact of moderate undernutrition on the development of the dermis and subcutis and suggest that critical epidermal functions such as skin barrier and pH are mostly maintained.

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“…The amounts of collagen in skin biopsies taken from children with clinical protein energy malnutrition were lower than those of controls (148). During pregnancy, not only is the collagen content of bones changed but the composition of the bones changes in fetal rats whose dams were protein or energy deficient (107).…”

Section: Amino Acid Deficiency Starvationmentioning

confidence: 99%