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On examination, there were macular ecchymoses with petechiae on the lower limbs. There was sparing of areas that had been compressed by the ankle-foot orthosis. Bloods showed mild thrombocytopaenia and anaemia with markedly raised inflammatory markers. Coagulation studies consistent with inflammation rather than disseminated intravascular coagulation. She was found to have <jats:italic>Klebsiella<\/jats:italic> bacteraemia secondary to urinary source. Skin biopsy showed dermal haemorrhage without vessel inflammation. Vitamin C levels were low confirming the diagnosis of scurvy.<\/jats:p>","DOI":"10.1136\/bcr-2020-237507","type":"journal-article","created":{"date-parts":[[2020,12,22]],"date-time":"2020-12-22T18:18:21Z","timestamp":1608661101000},"page":"e237507","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Scurvy presenting as lower limb ecchymoses in the setting of metastatic colorectal cancer"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0486-9013","authenticated-orcid":false,"given":"Joshua M","family":"Inglis","sequence":"first","affiliation":[{"name":"Royal Adelaide Hospital, Adelaide, South Australia, Australia"},{"name":"Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jia","family":"Tan","sequence":"additional","affiliation":[{"name":"Flinders Medical Centre, Bedford Park, South Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,12,18]]},"reference":[{"key":"2025082703450179000_13.12.e237507.1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4632.2006.02844.x"},{"key":"2025082703450179000_13.12.e237507.2","doi-asserted-by":"crossref","first-page":"1661","DOI":"10.1136\/bmj.316.7145.1661","article-title":"Scurvy in patients with cancer","volume":"316","author":"Fain","year":"1998","journal-title":"BMJ"},{"key":"2025082703450179000_13.12.e237507.3","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1016\/j.pathol.2018.07.004","article-title":"Vitamin C deficiency in an Australian cohort of metropolitan surgical patients","volume":"50","author":"Ravindran","year":"2018","journal-title":"Pathology"},{"key":"2025082703450179000_13.12.e237507.4","unstructured":"Australian Government National Health and Medical Research Council . 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