Scurvy-scorbutic siderosis of gingiva: A diagnostic challenge - A rare case report

Abstract

This case reports a rare condition of scurvy which posed a diagnostic difficulty. However, a thorough medical and diet history, along with clinical and histopathological examination aided in prompt diagnosis and successful management of the case. Occurrence of scurvy in today's contemporary society is said to be rare. Lack of fresh fruits and vegetables in the diet can lead to this condition. Diagnosis may be difficult due to its rarity and presence of non specific symptoms, which may pose a challenge to the clinician. A comprehensive history, clinical examination along with clinical and histopathological features led to arrive at a proper diagnosis. Local procedures and systemic therapy aided in the successful management of the case. A marked improvement in the gingival status and in the physical well being of the patient resulted after treatment. This case report describes the various manifestations of scurvy that posed a diagnostic challenge to the clinician. This condition which can be fatal if untreated can be easily prevented with inclusion of healthy food in the diet and modification in the lifestyle.

Keywords: Gingiva; scorbutic siderosis; scurvy; vitamin C.

Figure 1a

Keratotic patch on abdomen

Figure 1b

Hyperkeratotic patch at back of neck

Figure 1c

Keratotic patch on cheek region

Figure 1d

Palms showing small petechiae

Figure 2a

Clinical picture showing frontal view at initial visit

Figure 2b

Clinical view of left side at first visit

Figure 2c

Clinical picture showing blackish discoloration at the provocated sight

Figure 3

Gentle removal of slough with cotton pellet swabbed with hydrogen peroxide 3%

Figure 4a

Histopath picture showing hemorrhage

Figure 4b

Histopathological section showing spongiosis

Figure 5

OPG showing mild to moderate generalized bone loss

Figure 6a

Frontal view after 1 week

Figure 6b

Clinical picture after 1 week post treatment

Figure 7a

Post treatment view of left side after 3 months

Figure 7b

Post treatment view of right side after 3 months