What are the bleeding manifestations of vitamin C deficiency?¶
Answer: Scurvy causes bleeding from capillary and connective-tissue fragility due to impaired collagen synthesis. Manifestations include:
- Perifollicular hemorrhages — corkscrew or "swan-neck" hairs
- Petechiae, ecchymoses, and palpable purpuric lesions — present in ~80% of patients
- Splinter (subungual) hemorrhages
- Spontaneous hematomas and poor wound healing
- Other: gingival and oral bleeding in dentate patients; ophthalmic bleeding (flame-shaped retinal hemorrhages, eyelid/periorbital hemorrhage); musculoskeletal bleeding, reported in children
Onset typically follows 1–3 months of near-absent vitamin C intake, and spontaneous bleeding characteristically ceases within hours to days of repletion. See also Water-Soluble Vitamins: Deficiency and Excess (Pediatrics in Review).