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07-21-2024, 08:14 PM
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Scurvy Presenting with Severe Skin Changes
The Journal of Emergency Medicine Scurvy is a condition caused by a severe lack of dietary vitamin C, which is found in many fruits and vegetables. Vitamin C serves as an essential cofactor for collagen production. As an important structural protein, deficiencies in collagen formation result in fragile tissues and capillaries. (1) Physical examination findings of lower extremity edema, hyperkeratosis, poor wound healing, perifollicular petechiae, purpura, and corkscrew hair are all associated with scurvy. Treatment for scurvy is with vitamin C supplementation and modification to the dietary habits that led to the condition. (2)Presenting a case of a patient who presented to our Emergency Department (ED) for dramatic leg lesions and was found to have scurvy. Case Report A reclusive 56-year-old man with no medical history presented to the ED after three syncopal episodes. He had developed generalized weakness and progressive painless leg wounds over the past month. For the past several years he had some lower leg discoloration and a minimally varied diet. Vital signs showed mild hypothermia with intermittent bradycardia and hypotension. Physical examination revealed extensive circumferential ulcerating purpuric plaques with fibrinous and necrotic debris... The combination of perifollicular petechiae, purpuric rash, corkscrew hair, and an undetectable vitamin C level confirmed the diagnosis of scurvy. The dermatology consultants felt that long-standing stasis dermatitis had led to the development of elephantiasis nostras verrucosa, an exaggerated form of lymphedema. It was suspected that scurvy caused microvascular hemorrhage into his legs, causing the dramatic discolored appearance of the ulcerated purpuric plaques. (access to rest of case study can be found here because I'm not paying for it but you can if you want to) https://www.sciencedirect.com/scienc...36467922003353 |