What are the key clinical features to consider when diagnosing scurvy in adults?

Key clinical features to consider when diagnosing scurvy in adults include:

• General symptoms such as fatigue, malaise, and irritability, which often precede more specific signs.
• Cutaneous manifestations including perifollicular petechiae, purpura, and ecchymoses due to fragile capillaries and defective collagen synthesis.
• Gingival changes such as swollen, bleeding gums and periodontal disease, reflecting impaired connective tissue integrity.
• Musculoskeletal symptoms including joint pain, swelling, and muscle weakness, often related to subperiosteal hemorrhages and impaired bone formation.
• Poor wound healing and easy bruising, which are hallmark features of vitamin C deficiency.
• In severe or prolonged cases, systemic signs such as anemia and signs of infection may be present due to compromised immune function.

These clinical features arise from the essential role of vitamin C in collagen synthesis and maintenance of connective tissue integrity, leading to vascular fragility and impaired tissue repair (Francescone and Levitt, 2005). Macroscopic skeletal changes, such as subperiosteal hemorrhages and bone abnormalities, have also been described in human remains, supporting the musculoskeletal symptoms observed clinically (Snoddy et al., 2018). Early recognition of these signs is critical for diagnosis and prompt treatment to prevent progression.