Ref: Nelson's Textbook of Pediatrics. 19th Edition. Robbins Pathologic basis of disease, 8th edition. Page: & Vishnu Shot's Protein Energy Malnutrition. 1st ed.Peepee. Page: 121 135.Explanation:MARASMUS (Xonedeniatous malnutrition)It is characterized by failure to gain weight and irritability. followed by weight loss and listlessness until emaciation results.The skin loses turgor and becomes wrinkled and loose as subcutaneous fat disappears.Loss of fat from the sucking pads of the cheeks often occurs lateInfants are often constipated, but they can have starvation diarrhea, with frequent small stools containing mucus.The abdomen may be distended or flat. with the intestinal pattern readily visible.There is muscle atrophy and re su Itant hypotonia.Children often have Voracious appetiteAs the condition progresses, the temperature usually becomes subnormal (Hypothermia) and the pulse slowsKWASHIORKOR (Edematous malnutrition)It can occur initially as vague manifestations that include lethargy, apathy, and irritability.When kwashiorkor Is advanced, there is lack of growth. lack of stamina, loss of muscle tissue, increased susceptibility to infections, vomiting, diarrhea, anorexia, flabby subcutaneous tissues, and edema.Psychological changesThe edema usually develops early secondary to hypoalbum in emia.It is often present in internal organs before it is recognized in the face and limbs.Liver enlargement due to fatty liver can occur early or late in the course of disease.Dermatitis is common, with darkening of the skin in irritated areas, but in contrast to pellagra not in areas exposed to sunlight.Depigmentation can occur after desquamation in these areas, or it may be generalizedThe hair is sparse and thin, and in dark-haired children, it can become streaky red or gray.Eventually, there is stupor, coma and death