Scurvy masquerading as leukocytoclastic vasculitis: a case report and review of the literature

Abstract

Scurvy, a disease rarely seen in modern times, results from dietary deficiency of vitamin C and is characterized in adults by hemorrhagic diathesis, hair follicle abnormalities, and osteopenia. We present a 59-year-old man with perifollicular petechiae of the extremities, a painful lower extremity hematoma, and sacral osteopenia, who was repeatedly misdiagnosed with leukocytoclastic vasculitis. The patient's dietary history revealed several months of virtually no vitamin C intake. The patient rapidly improved with vitamin C replacement. We review the biochemical basis and pathophysiology of scurvy, clinical scenarios in which it occurs, clinical signs and radiologic features of the condition, and recommendations for its diagnosis and treatment.