{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T16:49:48Z","timestamp":1775666988141,"version":"3.50.1"},"reference-count":9,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T00:00:00Z","timestamp":1775606400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Reports"],"abstract":"<jats:p>Background and clinical significance: Scurvy, resulting from vitamin C deficiency, is rare in the 21st century, particularly in high-income settings. Its nonspecific presentation and ability to mimic a wide range of conditions make diagnosis incredibly challenging. Pseudovasculitic petechial lesions of the lower limbs may be misdiagnosed as systemic vasculitis, often leading to extensive investigations and delayed treatment. Case presentation: We report the case of a 45-year-old woman who presented with progressive lower limb pain, swelling, and vasculitis-like petechial rash with ecchymoses. Extensive investigations for autoimmune, infectious, malignant, and vascular causes, including skin biopsy, were unremarkable. A detailed dietary history revealed markedly restrictive intake. Characteristic dermatological findings, including perifollicular haemorrhage, ecchymoses and hair shaft abnormalities, raised suspicion for scurvy. Profoundly reduced serum ascorbic acid levels confirmed vitamin C deficiency. Conclusions: This case highlights the importance of thorough dietary assessment, recognition of characteristic cutaneous features, and identification of risk factors such as restrictive eating patterns or chronic gastrointestinal symptoms. It underscores the need for a high index of clinical suspicion for scurvy, even in contemporary high-income settings. Early diagnosis and vitamin C supplementation can result in rapid clinical improvement and prevent avoidable morbidity.<\/jats:p>","DOI":"10.3390\/reports9020114","type":"journal-article","created":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T15:26:39Z","timestamp":1775661999000},"page":"114","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pseudovasculitic Scurvy Mimicking Small Vessel Vasculitis: A Case Report"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-9001-6597","authenticated-orcid":false,"given":"Andrea C. R.","family":"Chieng","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Goulburn Valley Health, Shepparton, VIC 3630, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Branavan","family":"Sivagnanam","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Goulburn Valley Health, Shepparton, VIC 3630, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magnus H.","family":"Liew","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Goulburn Valley Health, Shepparton, VIC 3630, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Priyani","family":"Daluwatte","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Goulburn Valley Health, Shepparton, VIC 3630, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,8]]},"reference":[{"key":"ref_1","first-page":"615","article-title":"Death from scurvy on Vasco da Gama\u2019s first journey to India (1497\u20131499)","volume":"15","author":"Carnemolla","year":"2003","journal-title":"Med. Secoli."},{"key":"ref_2","unstructured":"Maxfield, L., Crane, J.S., and Daley, S.F. (2023). Vitamin C Deficiency, StatPearls Publishing."},{"key":"ref_3","unstructured":"Institute of Medicine (US) Panel on Dietary Antioxidants and Related Compounds (2000). Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids, National Academies Press."},{"key":"ref_4","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":"ref_5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4103\/ijdpdd.ijdpdd_22_21","article-title":"Histopathology of vasculitis: Classification, features, and differential diagnosis","volume":"9","author":"Mysore","year":"2022","journal-title":"Indian J. Dermatol. Dermatol. Leprol."},{"key":"ref_6","first-page":"1403","article-title":"Scurvy: Reemergence of nutritional deficiencies","volume":"54","year":"2008","journal-title":"Can. Fam. Physician"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1016\/S0083-6729(08)60779-7","article-title":"The anemia of scurvy","volume":"26","author":"Cox","year":"1969","journal-title":"Vitam. Horm."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"11","DOI":"10.3941\/jrcr.v16i9.4545","article-title":"Scurvy in a malnourished child: Atypical imaging findings","volume":"16","author":"Biswas","year":"2022","journal-title":"J. Radiol. Case Rep."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1093\/qjmed\/hcaf067","article-title":"Spontaneous intramuscular haemorrhage as a presentation of scurvy","volume":"118","author":"Sattar","year":"2025","journal-title":"QJM Int. J. Med."}],"container-title":["Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2571-841X\/9\/2\/114\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T16:00:12Z","timestamp":1775664012000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2571-841X\/9\/2\/114"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,8]]},"references-count":9,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["reports9020114"],"URL":"https:\/\/doi.org\/10.3390\/reports9020114","relation":{},"ISSN":["2571-841X"],"issn-type":[{"value":"2571-841X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,8]]}}}