Adult scurvy

Unlike most animals, which form ascorbic acid by metabolizing glucose, huma ns require an exogenous source. Vitamin C occurs primarily in fruits and ve getables, and scurvy develops from inadequate consumption of these sources, usually because of ignorance about proper nutrition, psychiatric disorders , alcoholism, or social isolation. The earliest symptom of scurvy occurring only after many weeks of deficient intake, is fatigue. The most common cut aneous findings are follicular hyperkeratosis, perifollicular hemorrhages, ecchymoses, xerosis, leg edema, poor wound healing, and bent or coiled body hairs. Gum abnormalities, which occur only in patients with teeth, include gingival swelling, purplish discoloration, and hemorrhages. Pain in the ba ck and joints is common, sometimes accompanied by obvious hemorrhage into t he soft tissue and joints. Syncope and sudden death may occur. Anemia is fr equent, leukopenia occasional. Treatment with vitamin C results in rapid, o ften dramatic, improvement.