Images in Clinical Medicine

Kim Eagle, M.D., Editor

Skin Findings in a Patient with Scurvy

Christoph M. Kronauer, M.D., and Hugo Bühler, M.D.

N Engl J Med 1995; 332:1611June 15, 1995

• Slide

Article

Figure 1 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 μmol per liter; normal concentration, >0.62 mg per deciliter [35 μmol 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.

Kim Eagle, M.D.

Christoph M. Kronauer, M.D.
Hugo Bühler, M.D.
City Hospital Waid, 8037 Zurich, Switzerland