Scurvy: A Forgotten Illness?
TLDR Scurvy still occurs today and can be diagnosed by symptoms like gum bleeding and a specific rash, confirmed by low vitamin C levels.
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.
