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Mucocutaneous features of scurvy Follicular hyperkeratotic papules appear first on the upper arms, often spreading to the legs and buttocks Perifollicular haemorrhages, purpura (which can be palpable), and ecchymoses on the legs Hairs are often twisted and fragile (corkscrew hairs, swan-neck hairs) Poor wound healing and re-opening of old healed scars Splinter haemorrhages in the nails Red, swollen gums in patients with teeth (particularly around the upper incisors) which may later become purple or black Bleeding from the gums Loosening and loss of teeth Purpura Ecchymoses Corkscrew hairs Images in this gallery of ecchymoses and corkscrew hairs from: Esteves A, Teixeira da Silva F, Carvalho J, Felgueiras P, Laranjeira P
Scenario 1: weekly injection from a multi-dose vial You take the vial from the fridge, draw your dose, and return it within 10 minutes
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