Scurvy: Difference between revisions
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==Background== | ==Background== | ||
*Nutritional deficiency of Vitamin C (Ascorbic acid) | *Nutritional deficiency of Vitamin C (Ascorbic acid) | ||
*Vitamin C is typically | *Vitamin C is typically found in fruits and vegetables. | ||
*Vitamin C is a cofactor for hydroxylation of proline and lysine amino acids in procollagen molecules, which is required for cross-linking collagen's triple helix. | *Vitamin C is a cofactor for hydroxylation of proline and lysine amino acids in procollagen molecules, which is required for cross-linking collagen's triple helix. | ||
*Scurvy therefore leads to unstable collagen and collagen fragility. | *Scurvy therefore leads to unstable collagen and collagen fragility. | ||
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***petechiae | ***petechiae | ||
***easy bruising | ***easy bruising | ||
*Vitamin C is also required for the disulfide bonding in hair leading to corkscrew appearance of hair. | *Vitamin C is also required for the disulfide bonding in hair leading to corkscrew appearance of hair. | ||
==Clinical Features== | ==Clinical Features== | ||
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==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{ | {{Purpura DDX}} | ||
{{Dental Problems DDX}} | {{Dental Problems DDX}} | ||
== | {{Vitamin deficiencies DDX}} | ||
Guided by clinical suspicion but confirmed with laboratory analysis of vitamin C levels. | |||
==Evaluation== | |||
*Guided by clinical suspicion but confirmed with laboratory analysis of vitamin C levels. | |||
==Management== | ==Management== | ||
Vitamin C supplementation. | *Vitamin C supplementation. | ||
==Disposition== | ==Disposition== | ||
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==References== | ==References== | ||
# Kluesner, Nicholas and Miller, daniel. “Scurvy: Malnourishment in the land of the plenty.” The journal of emergency medicine. Vol 46. no 4. pages 530-532. 2014. | #Kluesner, Nicholas and Miller, daniel. “Scurvy: Malnourishment in the land of the plenty.” The journal of emergency medicine. Vol 46. no 4. pages 530-532. 2014. | ||
# Maltos, andre, et al. “Scurvy in a patient with AIDS: case report.” Revista de sociedade brasileira de medicina tropical 44(1): 122-123. 2011. | #Maltos, andre, et al. “Scurvy in a patient with AIDS: case report.” Revista de sociedade brasileira de medicina tropical 44(1): 122-123. 2011. | ||
<references/> | <references/> | ||
[[Category:Dermatology]] | |||
[[Category:FEN]] | |||
Revision as of 21:19, 24 August 2017
Background
- Nutritional deficiency of Vitamin C (Ascorbic acid)
- Vitamin C is typically found in fruits and vegetables.
- Vitamin C is a cofactor for hydroxylation of proline and lysine amino acids in procollagen molecules, which is required for cross-linking collagen's triple helix.
- Scurvy therefore leads to unstable collagen and collagen fragility.
- leaking of vascular structures
- gingival bleeding
- petechiae
- easy bruising
- leaking of vascular structures
- Vitamin C is also required for the disulfide bonding in hair leading to corkscrew appearance of hair.
Clinical Features
- Gingival bleeding
- Easy bruising
- Petechiae
- Corkscrew hair
Differential Diagnosis
Petechiae/Purpura (by cause)
- Abnormal platelet count and/or coagulation
- Septicemia
- Idiopathic thrombocytopenic purpura (ITP)
- Hemolytic uremic syndrome
- Leukemia
- Coagulopathies (e.g. hemophilia)
- Henoch-Schonlein Purpura (HSP)
- Acute hemorrhagic edema of infancy (AHEI)
- Hypersensitivity vasculitis
- Primary vasculitides
- Wegener's
- Microscopic polyangiitis
- Eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome)
- Secondary vasculitides
- Trauma
Dentoalveolar Injuries
Odontogenic Infections
- Acute alveolar osteitis (dry socket)
- Acute necrotizing ulcerative gingivitis (trench mouth)
- Dental abscess
- Periapical abscess
- Periodontal abscess
- Ludwig's angina
- Pulpitis (dental caries)
- Pericoronitis
- Peritonsillar abscess (PTA)
- Retropharyngeal abscess
- Vincent's angina - tonsillitis and pharyngitis
Other
Vitamin deficiencies
- Vitamin A deficiency
- Vitamin B deficiencies
- Vitamin B1 deficiency (Thiamine)
- Vitamin B3 deficiency (Pellagra)
- Vitamin B9 deficiency (Folate)
- Vitamin B7 deficiency (Biotin)
- Vitamin B12 deficiency
- Vitamin C deficiency (Scurvy)
- Vitamin D deficiency (Rickets)
- Vitamin E deficiency
- Vitamin K deficiency
- Zinc deficiency
Evaluation
- Guided by clinical suspicion but confirmed with laboratory analysis of vitamin C levels.
Management
- Vitamin C supplementation.
Disposition
See Also
External Links
References
- Kluesner, Nicholas and Miller, daniel. “Scurvy: Malnourishment in the land of the plenty.” The journal of emergency medicine. Vol 46. no 4. pages 530-532. 2014.
- Maltos, andre, et al. “Scurvy in a patient with AIDS: case report.” Revista de sociedade brasileira de medicina tropical 44(1): 122-123. 2011.