Protein energy malnutrition cocurs when inadequate protein and calories are ingested. PEM is not confined to children and is common in hospitalized patients. PEM is diegnosed by a weight loss and hypoalbuminemia. We report a case of PEM in a 27-year-old man after Whipples operation. He had brittle hair, loss on the scalp and brownish colored papules with desquamation on extrem ties. Also he had erosion and fissuring on the perioral area and beef tongue. Treatment with zinc sulfate, albumin and vitamin resulted in a good response. (Kor J Dermatol 1994; 32(1): 130-133)