MICHAEL E.MINGMD, MSCE
CARRIE ANN RCUSACKMDSENAIT W.DYSONMDJACQUELINE M.JUNKINS-HOPKINSMDVINCENTLIUMDKARLA S.ROSENMANMD
Examination of the hematoxylin-eosin–stained biopsy specimen from a purpuric area of the skin revealed extravasated red blood cells in the dermis around the hair follicles. No signs of vasculitis were found. Scurvy was suspected and confirmed by a low level of ascorbic acid (0.2 mg/dL [to convert to micromoles per liter, multiply by 56.78]; reference range, 0.4-2.0 mg/dL). The patient had poor nutritional intake and had consumed only lentils for the past 2 years according to his family. He was treated with a transfusion of packed red blood cells and oral ascorbic acid (1 g/d). Within 20 days, the purpura and gum lesions had completely regressed and his anemia had resolved.
Gingival Hypertrophy and Anemia—Diagnosis. Arch Dermatol. 2009;145(2):195-200. doi:10.1001/archdermatol.2008.580-b