Scurvy mistaken for cutaneous vasculitis in an adult with obesity: A case report

Scurvy is an increasingly recognized but frequently overlooked nutritional deficiency in developed countries. We report a 55-year-old man with obesity and type 2 diabetes mellitus who presented with progressive petechiae and ecchymoses concerning for cutaneous vasculitis. Extensive hematologic, rheumatologic, infectious, and dermatologic evaluations, including skin biopsy, were unrevealing. Symptoms were initially attributed to aspirin use without improvement following dose reduction. Subsequent nutritional assessment revealed an undetectable plasma vitamin C level (<0.1 mg/dL) in the setting of chronically poor dietary quality with minimal fruit and vegetable intake. The patient was treated with vitamin C supplementation and nutrition counseling, with subsequent clinical improvement and normalization of vitamin C levels. This case highlights how micronutrient deficiencies may occur despite adequate food access and emphasizes the importance of dietary assessment in patients with unexplained bleeding manifestations to avoid diagnostic delay and unnecessary testing.