Scurvy

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Background

  • Nutritional deficiency of Vitamin C (Ascorbic acid)
  • Vitamin C is typically found in fruits and vegetables.
  • Vitamin C is a cofactor for hydroxylation of proline and lysine amino acids in procollagen molecules, which is required for cross-linking collagen's triple helix.
  • Scurvy therefore leads to unstable collagen and collagen fragility.
    • leaking of vascular structures
      • gingival bleeding
      • petechiae
      • easy bruising
  • Vitamin C is also required for the disulfide bonding in hair leading to corkscrew appearance of hair.

Clinical Features

Corkscrew hair in a patient with scurvy.
Petechiae in a patient with scurvy.
Bruising in a patient with scurvy.
Gingival bleeding in a patient with scurvy.

Differential Diagnosis

Petechiae/Purpura (by cause)

Dentoalveolar Injuries

Odontogenic Infections

Other

Vitamin deficiencies

Evaluation

  • Guided by clinical suspicion but confirmed with laboratory analysis of vitamin C levels.

Management

  • Vitamin C supplementation.

Disposition

See Also

External Links

References

  1. Kluesner, Nicholas and Miller, daniel. “Scurvy: Malnourishment in the land of the plenty.” The journal of emergency medicine. Vol 46. no 4. pages 530-532. 2014.
  2. Maltos, andre, et al. “Scurvy in a patient with AIDS: case report.” Revista de sociedade brasileira de medicina tropical 44(1): 122-123. 2011.