Guellich A, Tella E, Mahé E
Service de dermatologie et médecine vasculaire, hôpital Victor-Dupouy, 69, rue du Lieutenant-Colonel-Prud'hon, 95100 Argenteuil, France.
Service de dermatologie et médecine vasculaire, hôpital Victor-Dupouy, 69, rue du Lieutenant-Colonel-Prud'hon, 95100 Argenteuil, France.
Rev Med Interne. 2021 Mar;42(3):214-217. doi: 10.1016/j.revmed.2020.10.382. Epub 2020 Nov 14.
Scurvy is a clinical syndrome resulting from ascorbic acid deficiency. Although presently rare in the developed world, it continues to occur within certain susceptible populations, particularly the elderly and those with dietary habits with low vitamin C intake.
Two men aged 87 and 69 were referred with multifactorial, progressive ulceration of the lower limbs, without scarring, in a context of arterial disease and other associated comorbidities. In both cases, the level of vitamin C was undetectable. An improvement in the necrotic component and in the purpura was promptly observed after vitamin C supplementation.
Diagnosis of scurvy can be challenging. This report highlights the importance of maintaining a high index of suspicion for scurvy in atypical necrotic ulcerations of lower extremities with poor response to standard therapy especially in populations at high risk of vitamin C deficiency. Early diagnosis can improve patient prognosis.
坏血病是一种由维生素C缺乏引起的临床综合征。虽然目前在发达国家较为罕见，但在某些易感人群中仍有发生，特别是老年人以及那些维生素C摄入量低的饮食习惯人群。
两名分别为87岁和69岁的男性因下肢多因素进行性溃疡被转诊，溃疡无瘢痕形成，伴有动脉疾病和其他相关合并症。在这两个病例中，维生素C水平均检测不到。补充维生素C后，坏死成分和紫癜迅速得到改善。
坏血病的诊断可能具有挑战性。本报告强调，对于标准治疗反应不佳的非典型下肢坏死性溃疡，尤其是维生素C缺乏高危人群，保持对坏血病的高度怀疑指数非常重要。早期诊断可改善患者预后。
