[Atypical scurvy associated with anorexia nervosa].

Area of Science:

• Internal Medicine
• Nutritional Science
• Dermatology

Background:

• Scurvy (Barlow's disease) is characterized by vitamin C deficiency, typically causing cutaneous and mucosal lesions.
• This case report details an unusual presentation of scurvy in an adult female.

Observation:

• A 48-year-old woman presented with atypical skin manifestations including palmoplantar rash, edema, fissures, and purpura, but lacked typical gingival bleeding.
• She exhibited wasting syndrome (BMI 11.9 kg/m²), geographic tongue, and telogen effluvium.
• Laboratory tests revealed critically low vitamin C levels, cytolysis, and anicteric cholestasis.

Findings:

• The diagnosis of scurvy was confirmed by low vitamin C levels, purpuric petechiae, and rapid symptom resolution with vitamin C supplementation.
• Anorexia nervosa was diagnosed, representing an unusual age of onset for the condition and the likely etiology of the vitamin C deficiency.
• This presentation is rare, with only three previously reported cases of scurvy associated with anorexia nervosa since 1975.

Implications:

• Highlights the importance of considering scurvy in adults with atypical presentations, especially those with eating disorders.
• Underscores that classical oral symptoms are not always present in scurvy.
• Emphasizes the need for nutritional assessment in patients with anorexia nervosa to prevent severe deficiencies like scurvy.