​Dermatology - Scurvy

​Dermatology - Scurvy 
Scurvy is an acute or chronic illness that arises in newborns or children who exclusively consume processed milk or in adults who avoid salads and raw vegetables because of a dietary shortage of ascorbic acid (vitamin C). Pregnancy, lactation, and thyrotoxicosis—which is most prevalent in alcoholism—are precipitating factors.

After one to three months without vitamin C, lassitude, weakness, arthralgia, and myalgia are the symptoms of scurvy. A bleeding injury into the joints and periosteum of long bones causes excruciating swellings and, in children, epiphyseal separation. The rib borders are elevated and the sternum inclines inward.
Particularly on the lower legs, petechiae and follicular hyperkeratosis with perifollicular bleeding are lesions that can arise. These perifollicular hyperkeratotic papules, also known as corkscrew hairs, break up and bury the hair, and there are widespread, generally spread ecchymoses.
Splinter hemorrhages occur in nails. The gingiva are spongy, purple, enlarged, and prone to bleeding. Loss of teeth and tooth loosening are possible.


When serum ascorbic acid levels are nil, the diagnosis of macrocytic, normochromic, and normocytic anemia is made. Findings from X-rays are also diagnostic.
If left untreated, scurvy is lethal. When 4 g of ascorbic acid is administered, 100 mg/d is curative in a matter of days to weeks.