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A Case for Diagnosis (Avitaminosis G or C?). Presented by Dr. G. Marshall Crawford, Boston.
A. B., a man aged 74, presents red itching areas on the dorsum of each hand and the extensor surface of each forearm. The lesions are of six weeks' duration. He worked in the sun all summer, during which period the diet consisted chiefly of ice cream, cake and sandwiches. The lesions are both circumscribed and confluent and vary in size from 5 mm. to 8 cm. in diameter. Their color ranges from red to purplish red; the borders are elevated and the central portion of the areas are faded. Microscopic examination of a single lesion showed moderate hyperkeratosis with some follicular plugging. The corium showed infiltration of leukocytes with a tendency toward perivascular concentration.Examination of the blood disclosed an absence of vitamin C. The serum proteins amounted to 5.6 per cent. The erythrocyte