Ancient Bruises: a Case of Skin Lesions due to Vitamin C Deficiency
  • Dipti Rao
    Rijnstate Hospital Arnhem
  • Roeland F. Stolk
    Rijnstate Hospital Arnhem
  • Maaike H. de Blauw
    Rijnstate Hospital Arnhem
  • Marcel M.C. Hovens
    Rijnstate Hospital Arnhem
  • Robert-Jan Hassing
    Department of Internal Medicine, Rijnstate Hospital Arnhem


Scurvy, ascorbic acid, ecchymosis, psychiatric disease


Scurvy was a common 18th century disease caused by vitamin C deficiency. It presents with multiple non-specific symptoms and can lead to capillary fragility due to impaired collagen synthesis. We report the case of a 63-year-old woman who presented with fatigue, nausea and progressive skin lesions consisting of multiple ecchymoses on the legs as also described in the diary drawings of a navy doctor in the 19th century. The ascorbic acid level was undetectable low in the patient’s serum. However, treatment with 500 mg ascorbic acid daily dramatically improved the skin lesions within 5 days.



  • Carpenter KJ. The discovery of vitamin C. Ann Nutr Metab2012;61:259–264.
  • Hirschmann JV, Raugi GJ. Adult scurvy. J Am Acad Dermatol 1999;41:895–906.
  • Olmedo JM, Yiannias JA, Windgassen EB, Gornet MK. Scurvy: a disease almost forgotten. Int J Dermatol 2006;45:909–913.
  • McCord CP: Scurvy as an occupational disease. J Occup Med 1971;13:306–307,348–351,393–395,441–447,484–491,586–592.
  • Michiels M, Mellema M, Peters FP. Haemorrhages due to vitamin C deficiency. Scurvy in the 21st century. Ned Tijdschr Geneeskd 2010;154:A1638.
  • Views: 1149
    HTML downloads: 936
    PDF downloads: 421
    Figure2 downloads: 0
    Conflict of interest downloads: 0
    Conflict of interest2 downloads: 0
    Copyright downloads: 0
    Cover letter downloads: 0
    Untitled downloads: 0

    Published: 2015-10-19
    Issue: Vol. 2 No. 7 (2015) (view)

    How to cite:
    Rao D, Stolk RF, de Blauw MH, Hovens MM, Hassing R-J. Ancient Bruises: a Case of Skin Lesions due to Vitamin C Deficiency. EJCRIM 2015;2 doi:10.12890/2015_000297.