End stage scurvy in the developed world: A diagnostic conundrum but not to be mistaken for pyoderma gangrenosum

Stephanie T. Le, Jenny Z. Wang, Claire C. Alexanian, Stephanie Y. Johng, Forum B. Patel, Elizabeth A. Wang, Chelsea Ma, Reason Wilken, Michelle Y. Cheng, Emanual Michael Maverakis

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1024-1028
Number of pages5
JournalInternational Wound Journal
Volume16
Issue number4
DOIs
StatePublished - Aug 1 2019

Fingerprint

Scurvy
Pyoderma Gangrenosum
Malnutrition
Ascorbic Acid Deficiency
Diagnostic Errors
Ulcer
Lower Extremity
Differential Diagnosis
History
Physicians
Incidence
Population
Therapeutics

Keywords

  • ascorbic acid
  • pyoderma gangrenosum
  • scurvy
  • ulcers
  • wound healing

ASJC Scopus subject areas

  • Surgery
  • Dermatology

Cite this

End stage scurvy in the developed world : A diagnostic conundrum but not to be mistaken for pyoderma gangrenosum. / 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 Michael.

In: International Wound Journal, Vol. 16, No. 4, 01.08.2019, p. 1024-1028.

Research output: Contribution to journalArticle

Le, ST, Wang, JZ, Alexanian, CC, Johng, SY, Patel, FB, Wang, EA, Ma, C, Wilken, R, Cheng, MY & Maverakis, EM 2019, 'End stage scurvy in the developed world: A diagnostic conundrum but not to be mistaken for pyoderma gangrenosum', International Wound Journal, vol. 16, no. 4, pp. 1024-1028. https://doi.org/10.1111/iwj.13149
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 Michael. / End stage scurvy in the developed world : A diagnostic conundrum but not to be mistaken for pyoderma gangrenosum. In: International Wound Journal. 2019 ; Vol. 16, No. 4. pp. 1024-1028.
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