Scurvy: A Forgotten Illness?

    S. Mahlberg, Subhapradha Rangarajan, T. Sharma
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    Studysummary This case report reveals a diagnosis of scurvy in a 19-year-old woman, emphasizing the importance of considering vitamin C deficiency in patients with dietary restrictions presenting with specific skin and gum symptoms.
    Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer
    A 19-year-old female with developmental delay and poor dietary intake presented with symptoms of gumline bleeding and perifollicular eruptions. Dermoscopy examination revealed perifollicular petechiae and corkscrew hairs, leading to a suspicion of Scurvy. This was confirmed by serum levels of vitamin C <0.1 mg/dL and a histopathologic examination showing hyperkeratosis with irregular acanthosis of the epidermis and follicular spongiosis with erythrocyte extravasation adjacent to a hair follicle. Scurvy is caused by a deficiency in Vitamin C, which is involved in the synthesis of collagen, carnitine and catecholamines, and in gene expression and maintenance. In developed countries, patients with avoidant-restrictive food intake or renal imbalances are at risk of Scurvy. Therefore, it is crucial to consider Scurvy in patients presenting with petechiae and to perform a comprehensive physical exam to avoid misdiagnosis.
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