<prompt> A 6-month-baby presented with recurrent seizures and developmental delay. On examination there was alopecia and scaly skin rashes. Investigations revealed metabolic acidosis, elevated lactates ketonuria. What could be the underlying enzyme deficiency?Phenylalanine hydroxylaseEpimeraseMultiple carboxylaseGlucose 6 phosphatase  <response>: Skin rashes with presence of ketones and metabolic acidosis are all features of Multiple carboxylase deficiency. Phenylalanine hydroxylase deficiency- microcephaly, hypopigmentation, musty body odour Glucose 6 phosphatase deficiency- doll like facies 