In vitamin C deficiency, what is a distinctive skin finding?

In vitamin C deficiency, a distinctive skin finding is perifollicular hemorrhage. Vitamin C, or ascorbic acid, is essential for the synthesis of collagen, which is a key structural protein in the skin and other connective tissues. A deficiency in vitamin C leads to impaired collagen synthesis, which results in structural weaknesses and increased fragility of blood vessels.

Perifollicular hemorrhage manifests as small, tender bleeding points around hair follicles due to the rupture of these weakened blood vessels. This finding is quite characteristic of scurvy, the condition resulting from severe vitamin C deficiency, and typically presents alongside other symptoms such as gingival bleeding, joint pain, and fatigue.

While petechiae may also appear in vitamin C deficiency, their presence is less specific and can be attributed to a wide range of conditions, including other types of nutritional deficiencies or thrombocytopenia. A macular rash is not typically associated with vitamin C deficiency. Photodermatitis occurs as a reaction to sunlight exposure and is unrelated to vitamin C levels. Thus, perifollicular hemorrhage stands out as the distinctive cutaneous manifestation of vitamin C deficiency.