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February 1990

Spontaneous Adult Scurvy in a Developed Country: New Insight in an Ancient Disease

Author Affiliations

Service de Dermatologie Hopital Ste Marguerite 270 Bd Ste Marguerite BP 29 13277 Marseille Cedex 9, France

Arch Dermatol. 1990;126(2):249-251. doi:10.1001/archderm.1990.01670260121031

To the Editor.—  Scurvy has become very rare in developed countries. In most patients with spontaneous or experimental scurvy, investigation has been limited to standard laboratory tests or to exploration of ascorbic acid metabolism. The extensive investigations carried out on this patient provide new insight into the pathogeny of this ancient, but still poorly understood, disease.

Report of a Case.—  A 68-year-old patient was referred to our dermatology unit for an extensive purpura with severe anemia and weakness. His lower extremities were covered with large ecchymotic areas (Fig 1). Subungual hemorrhage was present (Fig 2). The calves were swollen, stiff, and painful. He was nearly edentulous, and marked gingivitis (Fig 3) was noted. His behavior was aggressive and unstable. Laboratory investigations rapidly ruled out coagulation disorders, hepatocellular diseases, septicemia, and viral hemorrhagic diseases. Echography showed the calf muscles to be infiltrated, probably with blood. Contrast venography revealed bilateral crural phlebothrombosis.

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