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Scurvy: a cutaneous clinical diagnosis
Roland T D Nguyen1, David M Cowley, James B Muir
1Mater Misericordiae Hospitals, Brisbane, Queensland, Australia. rolandtdnguyen@hotmail.com
The Australasian Journal of Dermatology
|February 13, 2003
Summary
Scurvy, a vitamin C deficiency, can present with a purpuric rash. Diagnosis involves diet history and ascorbic acid tolerance tests, crucial for identifying this treatable condition.
Area of Science:
- Internal Medicine
- Dermatology
- Nutritional Science
Background:
- Scurvy, a disease caused by vitamin C deficiency, is increasingly rare but can occur in specific patient populations.
- Risk factors include poor dentition, gastrointestinal issues, mental health conditions, and substance dependence.
- Chemotherapy-induced side effects can also lead to poor nutrient absorption and deficiency.
Observation:
- Two cases of scurvy are presented, both initially diagnosed via a purpuric rash.
- Specific cutaneous manifestations included perifollicular purpura, ecchymoses, and coiled corkscrew hairs.
- Patients presented with varied underlying conditions, including substance dependence and complications from chemotherapy for acute myeloid leukemia.
Findings:
- Dietary history was crucial in diagnosing scurvy in both cases.
- The ascorbic acid tolerance test served as a simple laboratory method for confirmation.
- Clinical presentation with characteristic skin findings aided in early diagnosis.
Implications:
- Highlights the importance of considering scurvy in patients with unexplained purpuric rashes.
- Emphasizes the role of nutritional assessment in patients with risk factors or gastrointestinal symptoms.
- Suggests the ascorbic acid tolerance test as a valuable diagnostic tool for scurvy.