Perifollicular hemorrhagic lesions and broken twisted hairs on legs
Keywords:
Scurvy, perifollicular hemorrhage, corkscrew hairs, bleeding gums, vitamin CAbstract
A 17-year-old girl presented with multiple perifollicular hemorrhagic lesions on legs for 2 weeks. There was history of intermittent gum bleeding for last 2 months. Clinical examination revealed follicular keratosis and broken twisted hair (corkscrew hair), in addition to hemorrhagic lesions. Perifollicular hemorrhagic lesions and corkscrew hair are virtually pathognomonic for scurvy. When specifically asked, mother revealed that the girl was on self-imposed diet with almost no citrus fruits. Based on history and clinical findings, diagnosis of scurvy was made. The response to vitamin C supplementation was very good and all the lesions disappeared within one month. Scurvy has been reported in increasing numbers in recent literature; hence, recognition of scurvy is essential to avoid many serious complications including internal bleeding and even, death.References
Goebel L, Buckler BS, Driscoll H et al. Scurvy. [cited 2011July 15]. Available from http://emedicine.medscape.com/article/125350-overview
Frey JL, Shehan JM. Unknown: cutaneous manifestations of scurvy. Dermatol Online J 2008; 14(6): 19. [cited 2011July 15]. Available from http://dermatology.cdlib.org/146/unknown/cutaneous/shehan2.html
Chaudhry SI, Newell EL, Lewis RR, Black MM. Scurvy: a forgotten disease. Clin Exp Dermatol 2005; 30: 735-6.
Mapp SJ, Coughlin PB. Scurvy in an otherwise well young man. Med J Aust 2006; 185: 331-2.
Cohen SA, Paeglow RJ. Scurvy: an unusual cause of anemia. J Am Board Fam Med 2001; 14(4). [cited 2011July 15]. Available from http://www.medscape.com/viewarticle/405856
Olmedo JM, Yiannias JA, Windgassen EB, Gornet MK. Scurvy: a disease almost forgotten. Int J Dermatol 2006; 45: 909-13.
Fain O. Musculoskeletal manifestations of scurvy. Joint Bone Spine 2005; 72: 124-8.
Riepe FG, Eichmann D, Oppermann HC et al. Infantile scurvy. Arch Pediatr Adolesc Med 2001; 155: 607-8.
Delanghe JR, Langlois MR, De Buyzere ML, Torck MA. Vitamin C deficiency and scurvy are not only a dietary problem but are codetermined by the haptoglobin polymorphism. Clin Chem 2007; 53: 1397-1400.
Maltos AL, da Silva LL, Bernardes AG Jr et al. Scurvy in a patient with AIDS: case report. Rev Soc Bras Med Trop 2011; 44: 122-3.
Christopher K, Tammaro D, Wing EJ. Early scurvy complicating anorexia nervosa. South Med J 2002; 95 (9). [cited 2011July 15]. Available from http://www.medscape.com/viewarticle/442901.