Adult scurvy.
Unlike most animals, which form ascorbic acid by metabolizing glucose, humans require an exogenous source. Vitamin C occurs primarily in fruits and vegetables, and scurvy develops from inadequate consumption of these sources, usually because of ignorance about proper nutrition, psychiatric disorders, alcoholism, or social isolation. The earliest symptom of scurvy, occurring only after many weeks of deficient intake, is fatigue. The most common cutaneous findings are follicular hyperkeratosis, perifollicular hemorrhages, ecchymoses, xerosis, leg edema, poor wound healing, and bent or coiled body hairs. Gum abnormalities, which occur only in patients with teeth, include gingival swelling, purplish discoloration, and hemorrhages. Pain in the back and joints is common, sometimes accompanied by obvious hemorrhage into the soft tissue and joints. Syncope and sudden death may occur. Anemia is frequent, leukopenia occasional. Treatment with vitamin C results in rapid, often dramatic, improvement. (J Am Acad Dermatol 1999;41:895-906.)


OBJECTIVE
At the conclusion of this learning activity, participants should be familiar with the history, pathogenesis, clinical features, and treatment of scurvy in adults.
Hirschmann
J V
JV
Puget Sound Veterans Affairs Medical Center and the University of Washington School of Medicine, USA.
Raugi
G J
GJ
D000328:Adult; D000818:Animals; D001205:Ascorbic Acid / Q000502:physiology; D002318:Cardiovascular Diseases / Q000209:etiology; D049668:History, 15th Century; D049670:History, 17th Century; D049671:History, 18th Century; D049672:History, 19th Century; D049673:History, 20th Century; D006801:Humans; D018673:Nutrition Policy; D012140:Respiratory Tract Diseases / Q000209:etiology; D012614:Scurvy / Q000150:complications / Q000266:history* / Q000628:therapy; D012871:Skin Diseases / Q000209:etiology
D001205:Ascorbic Acid