Vitamin C Deficiency Masquerading as Vasculitis in a Patient With Crohn's Disease

• Published in: Curēus (Palo Alto, CA) Vol. 16; no. 2; p. e55295
• Main Authors: Verma, Kritin K, Deligonul, Fatma Z, Chen, Helen, Tarbox, Michelle
• Format: Journal Article
• Language: English
• Published: United States Cureus 29.02.2024
• Subjects: Dermatology; vitamin c deficiency; vasculitis; histopathology (hp); scurvy; crohn's disease
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.55295

This case study features a 40-year-old male with Crohn's disease (CD) who was initially misdiagnosed with vasculitis but was later shown to have scurvy owing to vitamin C deficiency. The patient's diet was nearly exclusively made up of highly processed fast food, with no fresh fruits or vegetables. A mildly sensitive, violaceous rash on his lower legs, mild gingival hemorrhage and enlargement, and muscle soreness were among his symptoms. Anemia and undetectable vitamin C levels were discovered in laboratory studies. A skin sample revealed follicular hyperkeratosis, coiled hairs, and perifollicular bleeding, eliminating the possibility of vasculitis. Scurvy was confirmed by undetectable vitamin C levels and intramuscular bleeding discovered during a muscle biopsy. After one month of vitamin C administration, the patient's skin was entirely clear. This instance emphasizes the significance of taking vitamin C insufficiency into account in patients with CD and other disorders that can cause malabsorption. Misdiagnosis might result in unneeded treatments and medical expenses. Scurvy must be diagnosed as soon as possible because it might cause gastrointestinal/intracerebral hemorrhage and death.