Open AccessEnd stage scurvy in the developed world: A diagnostic conundrum but not to be mistaken for pyoderma gangrenosum
Author(s) -
Le Stephanie T.,
Wang Jenny Z.,
Alexanian Claire C.,
Johng Stephanie Y.,
Patel Forum B.,
Wang Elizabeth A.,
Ma Chelsea,
Wilken Reason,
Cheng Michelle Y.,
Maverakis Emanual
Publication year - 2019
Publication title -
international wound journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.867
H-Index - 63
eISSN - 1742-481X
pISSN - 1742-4801
DOI - 10.1111/iwj.13149
Subject(s) - pyoderma gangrenosum , medicine , scurvy , ascorbic acid , malnutrition , differential diagnosis , dermatology , disease , surgery , medical diagnosis , pediatrics , population , incidence (geometry) , intensive care medicine , pathology , vitamin c , chemistry , physics , food science , environmental health , optics
Scurvy is a clinical syndrome, resulting from ascorbic acid deficiency. Prevalence of the condition is now extremely low in the Western population and its diagnosis can be challenging without a high index of suspicion. When cases do present, they are often misdiagnosed initially. Therefore, a thorough history, physical exam, and laboratory evaluation are key to showing this now rare but extremely well‐known disease. We report a case of scurvy manifesting as persistent non‐healing lower‐extremity ulcerations, initially mistaken for pyoderma gangrenosum. The patient responded to appropriate replacement therapy, but ulcers were slow to heal. As was the case in our patient, symptom reversal may require additional nutritional replacement. We encourage physicians to consider nutritional deficiencies in their differential diagnoses and highlight the incidence of malnutrition in the proper clinical setting to avoid diagnostic delay.