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Scurvy in the present times: vitamin C allergy leading to strict fast food diet.
Dermatol Online J 2016; 22(1)DO

Abstract

Scurvy results from a deficiency of vitamin C, a nutrient otherwise known as ascorbic acid. Today, scurvy is rare yet emerges in select patients. The patient reported herein developed scurvy secondary to deliberate avoidance of vitamin C-rich foods. Classic cutaneous manifestations of scurvy include follicular hyperkeratosis and perifollicular hemorrhage encompassing coiled "corkscrew" hairs and hairs bent into "swan-neck" deformities. Ecchymoses, purpura, and petechiae are also characteristically prominent. Classic oral abnormalities include erythematous, swollen gingivae that hemorrhage from subtle microtrauma.Subungual linear splinter hemorrhages may also manifest as a sign of the disease. To establish the diagnosis requirements include characteristic physical exam findings, evidence of inadequate dietary intake, and rapid reversal of symptoms upon supplementation. Although unnecessary for diagnosis, histological findings demonstrate perifollicular inflammation and hemorrhage, fibrosis, and hyperkeratosis, amongst dilated hair follicles and keratin plugging. Although citrus fruit allergies have been historically documented, ascorbic acid has not been previously reported as an allergen. Although lacking absolute certainty, this report suggests a presumed case of ascorbic acid allergy based on patient history and favorable response to ascorbic acid desensitization therapy.

Authors+Show Affiliations

Massachusetts General Hospital.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

26990475

Citation

Shaath, Tarek, et al. "Scurvy in the Present Times: Vitamin C Allergy Leading to Strict Fast Food Diet." Dermatology Online Journal, vol. 22, no. 1, 2016.
Shaath T, Fischer R, Goeser M, et al. Scurvy in the present times: vitamin C allergy leading to strict fast food diet. Dermatol Online J. 2016;22(1).
Shaath, T., Fischer, R., Goeser, M., Rajpara, A., & Aires, D. (2016). Scurvy in the present times: vitamin C allergy leading to strict fast food diet. Dermatology Online Journal, 22(1).
Shaath T, et al. Scurvy in the Present Times: Vitamin C Allergy Leading to Strict Fast Food Diet. Dermatol Online J. 2016 Jan 15;22(1) PubMed PMID: 26990475.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Scurvy in the present times: vitamin C allergy leading to strict fast food diet. AU - Shaath,Tarek, AU - Fischer,Ryan, AU - Goeser,Megan, AU - Rajpara,Anand, AU - Aires,Daniel, Y1 - 2016/01/15/ PY - 2016/01/15/received PY - 2016/01/15/accepted PY - 2016/3/19/entrez PY - 2016/3/19/pubmed PY - 2017/1/10/medline JF - Dermatology online journal JO - Dermatol. Online J. VL - 22 IS - 1 N2 - Scurvy results from a deficiency of vitamin C, a nutrient otherwise known as ascorbic acid. Today, scurvy is rare yet emerges in select patients. The patient reported herein developed scurvy secondary to deliberate avoidance of vitamin C-rich foods. Classic cutaneous manifestations of scurvy include follicular hyperkeratosis and perifollicular hemorrhage encompassing coiled "corkscrew" hairs and hairs bent into "swan-neck" deformities. Ecchymoses, purpura, and petechiae are also characteristically prominent. Classic oral abnormalities include erythematous, swollen gingivae that hemorrhage from subtle microtrauma.Subungual linear splinter hemorrhages may also manifest as a sign of the disease. To establish the diagnosis requirements include characteristic physical exam findings, evidence of inadequate dietary intake, and rapid reversal of symptoms upon supplementation. Although unnecessary for diagnosis, histological findings demonstrate perifollicular inflammation and hemorrhage, fibrosis, and hyperkeratosis, amongst dilated hair follicles and keratin plugging. Although citrus fruit allergies have been historically documented, ascorbic acid has not been previously reported as an allergen. Although lacking absolute certainty, this report suggests a presumed case of ascorbic acid allergy based on patient history and favorable response to ascorbic acid desensitization therapy. SN - 1087-2108 UR - https://www.unboundmedicine.com/medline/citation/26990475/Scurvy_in_the_present_times:_vitamin_C_allergy_leading_to_strict_fast_food_diet_ L2 - http://www.diseaseinfosearch.org/result/6471 DB - PRIME DP - Unbound Medicine ER -