Early scurvy in the modern era: A case series
Abstract
CH: corkscrew hairs PE: perifollicular erythema INTRODUCTION Scurvy, or vitamin C deficiency, historically presented in those whose diet lacked fresh fruits and vegetables, classically including sailors and explorers. In modern times, scurvy is viewed as a rare condition; however, it continues to present even within highly developed nations due to malnutrition and unbalanced diets. According to trials by the National Health and Nutrition Examination Survey, the prevalence of vitamin C deficiency within the United States has reduced from 13% in 1988-1994 to 7.1% in 2003-2004. Ongoing cases of scurvy may be explained by the ongoing impact of the obesity epidemic. Additionally, alcohol and tobacco intake both impair ascorbic acid absorption, leading to a higher risk of scurvy. Vitamin C is implicated in fatty acid regulation, immune function, neurotransmitter generation, prostaglandin metabolism, and nitric oxide synthesis. Therefore, severe cases of scurvy may result in serious systemic functional deficits, and in untreated cases, even sudden death. Dermatologic findings associated with clinical scurvy include follicular hyperkeratosis, perifollicular hemorrhage, hair coiling (corkscrew hairs [CH]), and petechia. Mucosal findings include ecchymosis and gingivitis with recidivism and atrophy. A high index of suspicion is necessary, as clinical recognition is often the first line in diagnosis and timely treatment of scurvy. Here we present 5 cases of patients presenting to a…
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