An 83-year-old man with poor nutrition notices easy bruising and bleeding gums. On examination, he has inflamed bleeding gums, multiple areas of ecchymoses, and perifollicular hemorrhages. His coagulation profile and liver function is normal.For the patient with vitamin deficiency or excess, select the most likely diagnosis
Scurvy is characterized by a tendency to hemorrhage and perifollicular hyperkeratotic papules in which hairs become fragmented and buried. Gums are involved only if teeth are present. It can occur in infants 6-12 months of age who are on processed milk formulas, without citrus fruit or vegetable supplementation. The peak incidence in the United States is in poor and elderly people and alcoholics. It is frequently associated with other nutritional deficiencies (e.g., folic acid).
niacin
thiamine
pyridoxine
vitamin C
Endocrinology