<prompt> Kwashiorkor is characterised by all of the following features exceptEdema.Patchy depigmentation of hairFatty liverFatty infiltration of pancreas  <response>: Kwashiorkor and marasmus are manifestations of protein-energy malnutrition PEM.Marasmus represents the compensated phase of PEM.Kwashiorkor represents the uncompensated phase of PEM.KwashiorkorIt is characterized by following three essential features -1 EdemaEdema starts in lower extremities and later involves upper limbs and the face.Face appears moon shaped and puffy.a Edema is caused by -Hypoalbuminemia Major factorIncreased capillary permeability due to infection.Free radical injury to the cell membrane.2 Markedly retarded growthMuscles of the upper limb are wasted, but the lower extremities appear swollen due to oedema. a Muscle wasting is masked by oedema.3 Psychomotor mental changesThe child is lethargic, listless and apathetic in contrast to marasmus, where the child is alert and irritable.Appetite is impaired in contrast to marasmus, where children show voracious appetite.Other features of kwashiorkor1 HepatomegalyDue to fatty infiltration2 Hair changes in KwashiorkorHair is thin, dry and brittle, easily pluckableStraight and hypopigmentedFlag sign Alternate bands of Hypo and hyperpigmented hair corresponding to the period of under and proper nutrition.3 Skin changes in KwashiorkorLarge areas of skin show erythema followed by hyperpigmentationFlaky paint dermatitis Hyperpigmentation patches desquamate to expose raw hypopigmented areas. It gives the appearance of paint flaking off the surface of the wood.4 InfectionsThese children suffer from recurrent episodes of diarrhoea, respiratory and skin infections. 