Skin Findings in a Patient with Scurvy

Abstract

The legs of a 46-year-old man with scurvy are shown. The man had a mild mental disorder, and his diet consisted only of bread, pasta, packaged cookies, and water. Large ecchymotic areas extended over the backs of the legs (Panel A). A close-up (Panel B) shows perifollicular hemorrhages and hyperkeratotic papules in which hair is fragmented and buried. The plasma ascorbic acid concentration was 0.11 mg per deciliter (6.25 m mol per liter; normal concentration, Ͼ 0.62 mg per deciliter [35 m mol per liter]) after three days of a hospital diet. With a normal diet and vitamin C replacement therapy (500 mg orally per day), all findings disappeared within two and a half weeks.