Scurvy: A Disease not to be Forgotten

Area of Science:

• Clinical Medicine
• Nutritional Science
• Dermatology

Background:

• Presents a case of an 18-year-old male with a complex medical history including anxiety-depressive disorder and self-diagnosed food allergies leading to a restrictive diet.
• The patient exhibited significant physical symptoms including muscular pain, petechiae, ecchymosis, joint swelling, subcutaneous nodules, and gingival bleeding.
• Skin lesions were characterized by hyperkeratotic papules with coiled hairs and perifollicular hemorrhages.

Observation:

• An 18-year-old male presented with muscular pain, petechiae, ecchymosis, joint swelling, subcutaneous nodules, and gingival bleeding.
• Skin examination revealed hyperkeratotic papules with coiled hairs and perifollicular hemorrhages.
• The patient reported a history of mixed anxiety-depressive disorder and a restrictive diet for self-diagnosed food allergies.

Findings:

• Low serum ascorbic acid levels confirmed a diagnosis of scurvy.
• Allergy testing revealed cross-reactivity between pollens and foods due to panallergens.
• The patient was also diagnosed with celiac disease, indicating potential malabsorption.

Implications:

• Scurvy should be included in the differential diagnosis for patients presenting with petechiae and ecchymosis.
• Identifying underlying causes like restrictive diets, malabsorption (celiac disease), or psychiatric disorders is essential for managing scurvy.
• This case highlights the importance of a comprehensive diagnostic approach for complex presentations involving nutritional deficiencies and allergies.