Perifollicular hemorrhagic lesions and broken twisted hairs on legs

A 17-year-old girl presented with multiple perifollicular hemorrhagic lesions on legs for 2 weeks. there was history of intermittent gum bleeding for last 2 months. clinical examination revealed follicular keratosis and broken twisted hair (corkscrew hair), in addition to hemorrhagic lesions. perifollicular hemorrhagic lesions and corkscrew hair are virtually pathognomonic for scurvy. when specifically asked, mother revealed that the girl was on self-imposed diet with almost no citrus fruits. based on history and clinical findings, diagnosis of scurvy was made. the response to vitamin c supplementation was very good and all the lesions disappeared within one month. scurvy has been reported in increasing numbers in recent literature; hence, recognition of scurvy is essential to avoid many serious complications including internal bleeding and even, death.