Scurvy is still present in developed countries.
BACKGROUND
Scurvy, while uncommon, still occurs in developed countries despite the widespread availability of vitamins and fortified foods. A vitamin C deficiency prevalence of 10 to 14% in adults was reported in the National Health and Nutrition Examination Survey (NHANES) in 1994.


OBJECTIVE
We report the case of a 57-year-old male who presented with a combined vitamin C deficiency (scurvy) and a Zinc deficiency.


METHODS
He came to the emergency department complaining of a painful swollen ecchymotic leg and dyspnea. Prescriptions for narcotics did not relieve his symptoms. When a detailed dietary history was obtained, we added scurvy to the differential diagnosis. An extensive evaluation excluded trauma, coagulopathies, neoplasia, and vasculitides.


RESULTS
The combination of a classic skin biopsy and a low vitamin C level confirmed the diagnosis.


CONCLUSIONS
This presentation illustrates the necessity of including scurvy in the differential diagnosis of ecchymoses and demonstrates specific populations at risk: single adults and the elderly with deficient diets.
Velandia
Bertha
B
Department of Family Practice, University of Alabama, Huntsville, AL, USA.
Centor
Robert M
RM
McConnell
Vicky
V
Shah
Mobin
M
D000407:Alabama; D001205:Ascorbic Acid / Q000627:therapeutic use*; D001706:Biopsy; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008875:Middle Aged; D012614:Scurvy / Q000175:diagnosis*; D015032:Zinc / Q000172:deficiency*
D015032:Zinc; D001205:Ascorbic Acid