JAMES M.GRICHNIKMD, PhD
The lesions pictured are from the lower legs of a 56-year-old white man (Figure 1), a 32-year-old white woman (Figure 2), and a 77-year-old white man (Figure 3). All 3 patients presented with a lower extremity erythematous, hyperkeratotic, follicular-based process most notable on the lower legs (illustrated) and ecchymoses most notable on the thighs (not illustrated). All 3 were clinically diagnosed as having ascorbic acid deficiency. Laboratory ascorbic acid levels were available for the 56-year-old white man and were low, at less than 0.1 mg/dL (normal range, 0.6-2.0 mg/dL). His problems were precipitated by a diet that consisted only of snack cakes and frozen dinners.
Walters RW, Grichnik JM. Follicular Hyperkeratosis, Hemorrhage, and Corkscrew Hair. Arch Dermatol. 2006;142(5):658. doi:10.1001/archderm.142.5.658