ascorbic-acid and Purpura

Scurvy remains prevalent in certain populations, including addicts, people of low socioeconomic status, and the severely malnourished. It classically presents as follicular hyperkeratosis and perifollicular hemorrhage of the lower extremities, as well as bleeding in other areas such as the gingiva and joints. This case presentation and literature review highlights the common pathophysiological findings associated with scurvy and current methods of diagnosis and treatment.. The patient described in this case presented with sudden oligoarthritis and purpura of the lower extremities. Following progression of the patient's symptoms and a low vitamin C serum concentration, the patient was treated with vitamin C supplementation and dramatically improved. This was considered to be the result of an underlying vitamin C deficiency secondary to insufficient fruit and vegetable intake due to allergies.. This case highlights the importance of maintaining a high index of suspicion for scurvy in atypical presentations of purpura not better explained by another disease or in additional populations at high risk of vitamin C deficiency. Early diagnosis by either a primary care physician or dermatologist can expedite the treatment process and improve patient prognosis.

Topics: Aged; Arthritis; Ascorbic Acid; Female; Humans; Panniculitis; Purpura; Scurvy; Vitamins

Topics: Adult; Ascorbic Acid; Ascorbic Acid Deficiency; Diagnosis, Differential; Humans; Infant; Prognosis; Purpura; Scurvy

Topics: Ascorbic Acid; Avitaminosis; Blood Vessels; Cushing Syndrome; Diagnosis, Differential; Ehlers-Danlos Syndrome; Hemophilia A; Hemorrhagic Disorders; Humans; Purpura; Telangiectasia, Hereditary Hemorrhagic; Thrombocytopenia; Vascular Diseases

Topics: Adrenal Cortex Hormones; Adrenocorticotropic Hormone; Agranulocytosis; Anemia, Hemolytic; Anemia, Hemolytic, Autoimmune; Ascorbic Acid; Autoantibodies; Autoimmune Diseases; Blood Transfusion; Chloroquine; Colitis; Colitis, Ulcerative; Drug Hypersensitivity; Drug Therapy; Hemoglobinuria; Hemoglobinuria, Paroxysmal; Humans; Internal Medicine; Leukopenia; Lupus Erythematosus, Systemic; Neutrophils; Purpura; Purpura, Thrombocytopenic; Purpura, Thrombotic Thrombocytopenic; Splenectomy; Thrombocytopenia; Thyroiditis; Toxicology; Vitamins

Bateman purpura is characterized by diffuse senile skin atrophy, senile purpura and spontaneous stellar pseudocicatrices. Cutaneous changes in the course of ageing have been related to lower levels of ascorbic acid into the dermis of elderly people.. In this study, we postulate that senile purpura could be linked to dermal vitamin C deficiency and could be corrected by topical administration of this vitamin.. A 12-weeks, hemi-member (forearm or leg), randomized double-blind comparative study was conducted in 18 patients with Bateman purpura aged over than 60 years. At each visit, clinical assessment and biometrological measurements were performed. Clinical examination and scoring by experts showed a significant improvement on the vitamin C-treated side compared with the control, with reduction of haemorrhage areas, increase of dermal thickness.. Twice-daily application of 5% topical vitamin C led to a clinically apparent improvement of the skin symptoms and allows beneficial effects on skin elasticity and thickness. Bateman purpura, a classical sign of photoaging whose origin has not clearly been recognized could be improved by vitamin C applied on to the skin.. These results confirm the hypothesis of the underlying role of vitamin C deficiency in the determinism of Bateman purpura.

Topics: Administration, Cutaneous; Aged, 80 and over; Ascorbic Acid; Ascorbic Acid Deficiency; Colorimetry; Double-Blind Method; Elasticity; Humans; Purpura; Skin; Skin Aging; Skin Cream; Skinfold Thickness; Vitamins

Topics: Aged; Ascorbic Acid; Capillary Fragility; Clinical Trials as Topic; Glossitis, Benign Migratory; Humans; Niacinamide; Nutrition Disorders; Oral Manifestations; Placebos; Purpura; Pyridoxine; Riboflavin; Stomatitis; Thiamine; Tongue; Vitamins

Topics: Aged; Ascorbic Acid; Clinical Trials as Topic; Humans; Oral Hemorrhage; Purpura

Prolonged vitamin C deficiency can result in numerous metabolic abnormalities like impaired tissue repair and defective collagen synthesis. This case report describes a middle-age Japanese man presenting painful purpura on his lower limbs, severe anemia, and altered consciousness. The patient had been eating a selective diet lacking in vegetables and fruits since childhood. A serum analysis demonstrated a low level of vitamin C. The patient was treated with vitamin supplementation and psychological intervention. Scurvy is an under-considered illness with a favorable prognosis if diagnosed early while it is still sporadically encountered in some patients with malabsorption or malnutrition even in modern times.

Topics: Ascorbic Acid; Child; Humans; Leg; Male; Middle Aged; Pain; Purpura; Scurvy; Vitamins

Topics: Alcoholism; Ascorbic Acid; Ecchymosis; Foot; Humans; Leg; Male; Middle Aged; Purpura; Scurvy; Vitamins

A female patient presented with exertional dyspnea, myalgia, a petechial rash of the lower extremities and pronounced gingivitis. The biochemical test results showed the presence of anemia. The patient had a known eating disorder and on questioning about eating habits admitted that she did not eat any fruit or vegetables. This led to the suspicion of a vitamin C deficiency, which was confirmed by high-pressure liquid chromatography. The patient was subsequently treated with 1000 mg ascorbic acid daily for 1 month whereby the clinical symptoms and anemia improved within a few weeks.

Topics: Ascorbic Acid; Ascorbic Acid Deficiency; Dyspnea; Female; Gingivitis; Humans; Lower Extremity; Middle Aged; Myalgia; Purpura

Topics: Abdomen; Ascorbic Acid; Dermoscopy; Extremities; Humans; Male; Middle Aged; Purpura; Scurvy; Vitamins

Topics: Aging; Ascorbic Acid; Ascorbic Acid Deficiency; Double-Blind Method; Humans; Purpura; Scurvy

Topics: Ascorbic Acid; Ascorbic Acid Deficiency; Double-Blind Method; Humans; Purpura; Scurvy

Topics: Abdomen; Ascorbic Acid; Ascorbic Acid Deficiency; Female; Humans; Lower Extremity; Middle Aged; Purpura; Skin

Scurvy is defined as a deficiency of ascorbic acid, which is an essential exogenous vitamin in humans. Vitamin C is involved in collagen synthesis and its deficit can cause disorders of connective tissue. The most frequent symptoms are weakness, arthralgias, anorexia and depression, commonly associated with follicular hyperkeratosis and perifollicular hemorrhage, with purpura.. A young woman, with a history of malnutrition, manifested purpura and hematoma of the left lower limb. The laboratory tests didn't detect alterations either in coagulation, the platelet count or in the autoimmunity. The total body TC scan didn't show neoplasia or other suspected lesions. Excluding the most important causes of purpura, in consideration of malnutrition, scurvy was suspected.. A skin biopsy confirmed the diagnosis. Accordingly to this finding, a treatment with a daily intravenous infusion of vitamin C was started with consequent improvement of hematoma and purpura.. Scurvy is a re-emerging disease, also in western countries. When purpura appears in young adults, scurvy has to be investigated, especially when a history of malnutrition is present. The treatment with vitamin C infusions should be started as soon as possible in order to prevent any complications.

Topics: Ascorbic Acid; Female; Hematoma; Humans; Infusions, Intravenous; Lower Extremity; Malnutrition; Middle Aged; Purpura; Skin; Whole Body Imaging

Topics: Alcoholic Intoxication; Ascorbic Acid; Humans; Inflammatory Bowel Diseases; Male; Middle Aged; Purpura; Scurvy; Vasculitis

In Switzerland, vitamin C deficiency is a rare condition. Nonetheless, in clinical practice, there are some patients exhibiting a vitamin C deficiency as a result of an unbalanced diet or intestinal malabsorption. We report the clinical history of a 55-year-old man known for alcoholism and insufficient intake of fresh fruits and vegetables. He was admitted to the intensive care unit, for haemodynamic instability caused by blood loss due to fragile vessels (skin, gastrointestinal). Further analyses revealed a severe lack of vitamin C. The patient received a high dose of intravenous substitutive treatment, leading to a favourable clinical outcome.

Topics: Alcoholism; Anemia; Ascorbic Acid; Ascorbic Acid Deficiency; Diet; Hemodynamics; Humans; Male; Malnutrition; Middle Aged; Purpura; Switzerland

This patient was a liver transplant recipient and had a history of malnutrition. One tell-tale sign on the physical exam, however, left no doubt as to the diagnosis.

Topics: Ascorbic Acid; Ascorbic Acid Deficiency; Contusions; Female; Humans; Middle Aged; Purpura; Treatment Outcome

Scurvy is the classic and most severe form of vitamin C deficiency. This condition has become extremely rare among children in the industrialized countries.. We report the case of two boys presenting bone pain associated with haemorrhagic gingivitis, with perifollicular purpura of the lower limbs in one boy. The children had an unbalanced diet. Scurvy was associated with vitamin D and iron deficiency. The dermatological and radiological abnormalities seen were characteristic and a favourable outcome was rapidly obtained following supplementation.. The possibility of this forgotten historical illness should not be overlooked in the presence of these dermatological and rheumatologic signs, since this can help avoid unnecessary or excessively aggressive investigations.

Topics: Anemia, Iron-Deficiency; Ascorbic Acid; Child; Diagnosis, Differential; Gingival Hemorrhage; Humans; Lower Extremity; Male; Purpura; Rare Diseases; Risk Factors; Scurvy; Severity of Illness Index; Treatment Outcome; Vitamin D Deficiency; Vitamins

A 49-year-old man presented to hospital with severe orthostatic hypotension, gingival dysplasia and a purpuric rash involving his extremities. The orthostatic hypotension failed to respond to fluids and, on the basis of physical examination and dietary history, the patient was given a preliminary diagnosis of scurvy (ascorbic acid deficiency). Serum ascorbic acid levels were undetectable and the orthostasis was resolved within 24 h of ascorbic acid replacement. The pathogenesis of orthostatic hypotension in the setting of scurvy appears to involve impaired catecholamine synthesis and attenuated vasomotor response to α-adrenergic stimulation. We believe that this case describes a rare presentation of scurvy and highlights a previously under-reported connection between scurvy and vasomotor instability.

Topics: Ascorbic Acid; Gingival Diseases; Humans; Hypotension, Orthostatic; Male; Middle Aged; Purpura; Scurvy; Vitamins

Topics: Ascorbic Acid; Ascorbic Acid Deficiency; Autistic Disorder; Child; Down Syndrome; Humans; Male; Purpura; Scurvy

Progressive pigmented purpuric dermatosis (PPPD, Schamberg disease) is a rare benign, but chronic dermatosis frequently misdiagnosed as vasculitis or bleeding disorder. Although affected patients experience significant impairment in quality of life no effective treatment has been established. The aim of our two center case series was to evaluate efficacy and tolerability of the antioxidants rutoside and ascorbic acid as combination treatment for PPPD.. A retrospective review was performed on 35 patients with PPPD treated with 2 × 50 mg rutoside and 1,000 mg ascorbic acid daily between 2004 until 2011. The mean treatment duration was 8.2 months.. 71.4% of the participants experienced complete clearance and 20.0% an improvement of more than 50%, accompanied by increased quality of life. Nine participants (25.1%) relapsed after discontinuation. In seven, rutoside and ascorbic acid was re-initiated, and all responded again. Only three participants reported mild adverse effects. Participants with shorter disease duration showed better therapeutic success, shorter time to response and lower risk of recurrence.. Oral rutoside and ascorbic acid may be an efficient and well tolerated treatment for PPPD. Early treatment is recommended to achieve best clinical outcome.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Ascorbic Acid; Child; Drug Therapy, Combination; Female; Germany; Humans; Male; Middle Aged; Pigmentation Disorders; Purpura; Retrospective Studies; Rutin; Treatment Outcome; Young Adult

Topics: Ascorbic Acid; Canada; Edema; Female; Humans; Lower Extremity; Magnetic Resonance Imaging; Middle Aged; Pain; Purpura; Scurvy; Vitamins

Topics: Adult; Ascorbic Acid; Humans; Leg Dermatoses; Male; Purpura; Scurvy; Vitamins

We report a 23-year-old female patient with a 4-month history of transitory pigmented purpuric dermatoses (PPD). She was otherwise healthy and reported no history of previous medication intake and none of her family members had any disorders. Clinical examination revealed well-demarcated, brownish hyperpigmented, reticulated pigmentation with pinhead-sized purpura. The histopathological specimen was characterized by a mild epidermal hyperkeratosis, elongated rete ridges, papillomatosis and mild mononuclear cell infiltration in the superficial dermis with focal extravasations of red blood cells without siderophage. Despite prominent extravasations of red blood cells and edema both in the papillary dermis and the subpapillary layer, no definite capillaritis was seen. Based on these clinicohistopathological findings, the diagnosis of transitory PPD was considered to be most compatible. Clinicians should recognize the unique but rarely acknowledged disease as a subtype of pigmented purpuric dermatoses.

Topics: Adult; Ascorbic Acid; Asian People; Female; Humans; Pantothenic Acid; Purpura; Skin; Skin Diseases; Treatment Outcome

Topics: Aged; Alcoholism; Ascorbic Acid; Dermoscopy; Erythrocytes; Fibrosis; Fruit; Hair Follicle; Humans; Keratosis; Male; Malnutrition; Mouth, Edentulous; Purpura; Remission Induction; Scurvy; Skin Pigmentation; Vegetables

Progressive pigmented purpura (PPP) is a group of dermatoses that are benign and usually self-limited. However, they may persist for months or years with frequent recurrences. Numerous treatments have been tried, but no effective therapy has yet proven to be successful. This report documents the treatment of a patient with one subtype of PPP using ascorbic acid and a bioflavonoid rutoside given orally. A 42-year-old male with biopsy-proven Eczematoid-like Purpura of Doucas and Kapetanakis was treated with ascorbic acid 500 mg twice a day and a bioflavonoid rutoside 50 mg twice a day. Treatment was successful, with quick defervescence of the rash and no recurrence to date.

Topics: Administration, Oral; Adult; Ascorbic Acid; Buttocks; Diagnosis, Differential; Drug Therapy, Combination; Flavonoids; Humans; Leg; Male; Pigmentation Disorders; Purpura; Rutin

Topics: Adult; Alcoholism; Ascorbic Acid; Humans; Male; Purpura; Scurvy; Treatment Outcome

Scurvy is a nondiscriminatory disease process resulting from a nutritional deficiency of ascorbic acid (vitamin C). The severe vitamin deficiency produces a breakdown in the cellular structure of the body. This case report describes a middle-age woman with a history of edema, bruising of the lower extremities, anemia, and severe periodontal disease. Her presentation and medical history are classic for the signs of scurvy. Scurvy is now only uncommonly seen in developed countries, but there are still vulnerable populations whose nutritional status can lead to scurvy. The aim of this report is to help the clinician identify and treat scurvy, a disease that was once feared for its high mortality but is now easily treatable, even in cases that have progressed to multiple organ dysfunction and failure.

Topics: Adult; Anemia; Ascorbic Acid; Female; Gingivoplasty; Halitosis; Humans; Periodontal Diseases; Purpura; Scurvy; Tooth Extraction; Vitamins

Topics: Adult; Ascorbic Acid; Ascorbic Acid Deficiency; Chronic Disease; Colitis, Ulcerative; Diagnosis, Differential; Dietary Proteins; Ecchymosis; Fruit; Gastritis; Humans; Male; Middle Aged; Purpura

Topics: Abdomen; Ascorbic Acid; Humans; Male; Middle Aged; Purpura; Scurvy; Skin Diseases

The risk of vitamin C deficiency is underestimated in industrialized countries and is only disclosed in rare cases of severe scurvy.. We report three cases of scurvy presenting with ecchymotic purpura and hemorrhagic ulcerations of the lower limbs. Vitamin C supplementation led to rapid improvement of the skin lesions.. Clinical diagnosis of low-grade deficiency can be difficult. Biological diagnosis requires special care in sample taking and transport.

Topics: Aged; Aged, 80 and over; Ascorbic Acid; Ascorbic Acid Deficiency; Diagnosis, Differential; Ecchymosis; Female; Hemorrhage; Humans; Leg Dermatoses; Leg Ulcer; Purpura; Risk Factors; Scurvy

Bioflavonoids and ascorbic acid have been shown to increase capillary resistance and to mediate potent antioxidative radical scavenging activities.. We evaluated the clinical effect of oral bioflavonoids and ascorbic acid in patients with chronic progressive pigmented purpura (PPP).. In an open pilot study, oral rutoside (50 mg twice a day) and ascorbic acid (500 mg twice a day) were administered to 3 patients with chronic PPP.. At the end of the 4-week treatment period, complete clearance of the skin lesions was achieved in all 3 patients. No adverse reactions were noted. All patients remained free of lesions at the end of 3 months after treatment.. Our results suggest a beneficial effect of bioflavonoids in combination with ascorbic acid on PPP. Because the disease is mostly resistant to other treatment modalities, placebo-controlled studies are necessary to determine the usefulness of this therapy in PPP.

Topics: Administration, Oral; Adult; Aged; Antioxidants; Ascorbic Acid; Child; Female; Flavonoids; Humans; Pigmentation Disorders; Pilot Projects; Purpura; Rutin

We report a case of scurvy. This case is interesting by the unilateral character of the ecchymotic leg's purpura. Ascorbic acid assays do not yet enable subclinical vitamin C deficiency to be reliably detected. Hence the importance of knowing the situation which expose to this deficiency.

Topics: Anemia, Hypochromic; Ascorbic Acid; Darier Disease; Humans; Male; Middle Aged; Purpura; Scurvy

Topics: Ascorbic Acid; Darier Disease; Humans; Leg Dermatoses; Male; Middle Aged; Purpura; Scurvy

This report is on a patient, who presented purpura and hemarthrosis in a context of vitamin C deficiency. This case gives us the opportunity to discuss the differential diagnosis, the clinical features, the pathogenicity and the treatment of this rare condition.

Topics: Ascorbic Acid; Diagnosis, Differential; Hemarthrosis; Humans; Male; Middle Aged; Purpura; Scurvy

Scurvy is now an uncommon condition in the western world. We report a case of scurvy in a 14-year-old female with an inadequate diet who developed a purpuric rash affecting her trunk and legs. The rash resolved dramatically with ascorbic acid therapy.

Topics: Adolescent; Ascorbic Acid; Diet; Female; Humans; Purpura; Scurvy; Skin

A case of vascular purpura of the lower limbs in a 67 year old man is described. A diagnosis of scurvy was made in consideration of the absence of signs of vasculitis on skin biopsy, the history of a diet extremely poor in vitamin C and the prompt resolution of clinical picture with administration of vitamin C. The authors emphasize the importance of taking into consideration scurvy in the differential diagnosis of vascular purpura: this may spare expensive investigations and a dangerous delay in appropriate therapy.

Topics: Aged; Ascorbic Acid; Diagnosis, Differential; Humans; Leg; Male; Purpura; Scurvy

The role of vitamin C in maintaining mucosal health is poorly documented. The purpose of this study was to examine the presence of oral mucosal lesions in subjects with low ascorbic acid (AA) levels in plasma. AA plasma levels of 843 working elderly people in six rural villages in Eastern Finland were determined. All subjects with low plasma AA levels (< or = 25 mumol/l) (n = 106) formed the study group. Controls with normal AA levels (> or = 50 mumol/l) (n = 103) were drawn from the same population. They were matched for age, sex and number of teeth. Oral mucosal lesions in all subjects were recorded clinically using a double-blind method in all subjects. Petechias, leukoplakia and lichenoid lesions were the commonest lesions of the oral mucosa. Only in leukoplakia there was a statistically significant difference between the groups (p < 0.01). Smokers had more leukoplakia than non-smokers. The prevalence of leukoplakia was higher when smoking was combined with AA deficiency.

Topics: Adult; Ascorbic Acid; Ascorbic Acid Deficiency; Double-Blind Method; Female; Humans; Leukoplakia, Oral; Lichenoid Eruptions; Male; Middle Aged; Mouth Diseases; Mouth Mucosa; Prevalence; Purpura; Smoking; Surveys and Questionnaires

With reference to a case of vitamin C deficiency in a strict vegetarian, the authors recall the clinical findings and current diagnostic procedures in scurvy. Serum and urine ascorbic acid assays are now available and established the diagnosis. Management rests upon vitamin C given in a curative dosage of 1 to 2 g per day for 15 days followed by a preventive dosage of 10 mg per day.

Topics: Adult; Anemia; Ascorbic Acid; Ascorbic Acid Deficiency; Diet; Humans; Male; Purpura; Scurvy

Scurvy was diagnosed in two elderly alcoholic men in our emergency department. Both were ambulatory and had perifollicular petechiae and ecchymoses of the lower extremities and hypertrophic erythematous gingival lesions. There diets were deficient in fresh fruits and vegetables. Treatment with oral ascorbic acid resulted in dramatic resolution of the signs and symptoms. The first patient was admitted to the hospital, where extensive diagnostic studies failed to reveal other etiological explanations for the cutaneous lesions. The second patient was successfully treated as an outpatient.

Topics: Aged; Alcoholism; Ascorbic Acid; Diagnosis, Differential; Humans; Male; Middle Aged; Nutritional Requirements; Purpura; Scurvy

Topics: Adenosine Diphosphate; Adult; Aged; Animals; Ascorbic Acid; Blood; Blood Cell Count; Blood Coagulation Factors; Blood Platelets; Collagen; Humans; Leukocytes; Methods; Platelet Adhesiveness; Purpura; Scurvy; Snakes; Venoms

Topics: Acute Disease; Age Factors; Ascorbic Acid; Calcium; Cerebral Hemorrhage; Cortisone; Diet Therapy; Glomerulonephritis; Gluconates; Humans; Male; Middle Aged; Purpura; Rheumatic Diseases; Rutin; Vitamin K

Topics: Aged; Angiomatosis; Arteriosclerosis; Ascorbic Acid; Glomerulonephritis; Humans; Hypertension; Keratosis; Male; Nails; Pressure; Purpura

Topics: Aged; Aging; Ascorbic Acid; Ascorbic Acid Deficiency; Blood; Humans; Leukocytes; Middle Aged; Purpura

Topics: Adult; Aged; Anti-Bacterial Agents; Ascorbic Acid; Drug Hypersensitivity; Erythema Multiforme; Female; Humans; Hypersensitivity, Delayed; Hypersensitivity, Immediate; Infant; Male; Middle Aged; Oxyphenbutazone; Penicillins; Pigmentation Disorders; Prednisolone; Purpura; Rutin; Skin Tests; Stevens-Johnson Syndrome; Surgical Procedures, Operative; Urea

Topics: Adrenocorticotropic Hormone; Ascorbic Acid; Blood Coagulation Disorders; Diagnosis; Drug Therapy; Fibrinolysis; Humans; Ischemia; Necrosis; Pathology; Prednisone; Promethazine; Purpura; Purpura Fulminans; Tetracycline

Topics: Adrenocorticotropic Hormone; Ascorbic Acid; Blood Coagulation Disorders; Diagnosis; Drug Therapy; Fibrinolysis; Humans; Ischemia; Necrosis; Pathology; Prednisone; Promethazine; Purpura; Purpura Fulminans; Tetracycline

Topics: Adrenal Cortex Hormones; Adrenocorticotropic Hormone; Aminocaproates; Aminocaproic Acid; Ascorbic Acid; Fibrinolysis; Hemorrhagic Disorders; Homeostasis; Humans; Physiology; Purpura; Purpura, Thrombocytopenic; Thrombocytopenia

Topics: Adrenocorticotropic Hormone; Anti-Allergic Agents; Ascorbic Acid; Calcium; Calcium, Dietary; Ephedrine; Epinephrine; Histamine H1 Antagonists; IgA Vasculitis; Prednisone; Purpura

Topics: Arsenic; Ascorbic Acid; Diagnosis, Differential; Drug Therapy; Eczema; Egypt; Hemosiderosis; Histamine H1 Antagonists; Humans; Pathology; Pruritus; Purpura

Topics: Adrenal Cortex Hormones; Adrenocorticotropic Hormone; Anti-Bacterial Agents; Antibiotics, Antitubercular; Ascorbic Acid; Dermatologic Agents; Dermatology; Purpura; Vascular Diseases

Topics: Administration, Oral; Aniline Compounds; Ascorbic Acid; Chalcones; Coloring Agents; Flavonoids; Hemophilia A; Hesperidin; Hypoprothrombinemias; Leukemia; Prothrombin; Purpura; Purpura, Thrombocytopenic; Tolonium Chloride; Vitamins

Topics: Ascorbic Acid; IgA Vasculitis; Purpura; Vitamins