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Scurvy in Child
See also in: Oral Mucosal Lesion
Other Resources UpToDate PubMed

Scurvy in Child

See also in: Oral Mucosal Lesion
Contributors: Christine S. Ahn MD, FAAD, William W. Huang MD, MPH, FAAD, Susan Burgin MD
Other Resources UpToDate PubMed


Scurvy is an acquired condition caused by a deficiency of vitamin C (L-ascorbic acid). Humans are unable to synthesize vitamin C; hence, it must be consumed in the diet. Deficiency of this essential nutrient causes impaired collagen synthesis, which leads to poor wound healing, capillary fragility, and bone abnormalities (eg, osteoporosis, fractures, bone marrow edema, demineralization, intraosseous hemorrhage). In developed countries, scurvy is a relatively rare diagnosis primarily found in older adults, those who abuse alcohol, and infants and children.

Scurvy can present with wide clinical variation, including dermatologic, dental, bone, and systemic manifestations. Clinical features of scurvy may be observed within 8 weeks of inadequate intake of vitamin C. The initial symptoms include irritability, decreased appetite, and low-grade fever. Dermatologic signs include xerosis, hyperkeratosis, perifollicular hemorrhage, scattered petechiae and ecchymoses, and corkscrew hairs. Oral findings include swollen, friable gingiva. In children, scurvy can present with joint swelling and refusal to walk, and bone growth may be inhibited. Rare presentations of scurvy include proptosis due to orbital hemorrhage, skeletal muscle degeneration, cardiac hypertrophy, psychological changes, edema, and alopecia. Untreated, scurvy can be fatal; deaths have been reported due to infection, cerebral hemorrhage, or hemopericardium.

In pediatric populations, at-risk individuals include those with iron overload, neurologic disorders, a history of bone marrow transplant, and/or chemotherapy. Additionally, children with restricted diets, especially in the setting of autism or developmental delay, are at increased risk.


E54 – Ascorbic acid deficiency

76169001 – Scurvy

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Differential Diagnosis & Pitfalls

Cutaneous manifestations:
  • Autoimmune conditions (eg, Immunoglobulin A vasculitis [formerly Henoch-Schönlein purpura], Systemic lupus erythematosus, Sjögren syndrome)
  • Rocky Mountain spotted fever
  • Acute meningococcemia
  • Ehlers-Danlos syndrome
  • Cryoglobulinemia
  • Disorders of platelet function
  • Clotting factor deficiencies
  • Hematologic malignancy
  • Primary syphilis
  • Physical child abuse and Neglect
Failure to walk or limb pain:
  • Transient synovitis of hip (often following viral infection or trauma) 
  • Juvenile idiopathic arthritis
  • Reactive arthritis
  • Septic arthritis 
  • Osteomyelitis
  • Malignancy (such as leukemia, metastases, primary bone tumors)
Oral mucosal manifestations:
  • Chronic gingivitis / Periodontitis 
  • Necrotizing ulcerative gingivitis 
  • Leukemic gingivitis (most often associated with myelomonocytic forms of leukemia)

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Last Reviewed:10/03/2017
Last Updated:08/30/2023
Copyright © 2024 VisualDx®. All rights reserved.
Scurvy in Child
See also in: Oral Mucosal Lesion
A medical illustration showing key findings of Scurvy (Initial Stage) : Diarrhea, Fatigue, Fever, Malaise, Anorexia, Tachypnea, Poor weight gain
Clinical image of Scurvy - imageId=2760850. Click to open in gallery.  caption: 'A close-up of scattered perifollicular purpura and "corkscrew" hairs.'
A close-up of scattered perifollicular purpura and "corkscrew" hairs.
Copyright © 2024 VisualDx®. All rights reserved.