Scurvy as the tip of the iceberg

Scurvy is thought to be a disease of the past that has long been forgotten. Historically, James Lind, a Scottish physician, wconducted the first ever clinical trial in an attempt to find a cure for scurvy in sailors in 1746, and found out that citrus fruits helped cure the disease (Carpenter, 1785). Although symptoms of scurvy have long been known before that clinical trial and since the 15th century (Leger, 2008), but the there was no clear etiology or treatment for the disease (Carpenter, 1785). Scurvy has a number of clinical manifestations leading to changes in bones, skin, and mucous membranes. Usually, it takes a person one to three months to develop scurvy after a diet deficient in Vitamin C (Ascorbic acid) (Bolognia et al., 2008). Symptoms dramatically improve after vitamin C supplementation (Bolognia et al., 2008). Nowadays, we rarely see patients presenting with scurvy, but we need to think about it in patients with food faddisms, alcoholism, and poor nutrition due to any cause such as anorexia nervosa, malabsorption such as due to inflammatory bowel disease, celiac disease and severe food allergies. Here, we report a case of a 48 year old gentleman who presented to the dermatology clinic with clinical manifestations of scurvy.