skorbut

Skorbut, or scurvy, is a deficiency disease caused by insufficient vitamin C (ascorbic acid). Humans cannot synthesize vitamin C and must obtain it from the diet. Vitamin C is essential for collagen synthesis, acting as a cofactor for the enzymes prolyl and lysyl hydroxylases, which stabilize connective tissue.

Symptoms develop after weeks of deficiency and include fatigue, gum inflammation and bleeding, tooth loss, joint and muscle pains, easy bruising, dry skin, corkscrew hairs, and poor wound healing. In children, scorbutic rosary (bony enlargements at the rib cage) may appear.

Pathophysiology: lack of collagen leads to weakness of blood vessels and connective tissue, causing bleeding, edema, and anemia in prolonged cases. Risk groups include people with very restricted diets, alcoholism, malabsorption, or certain chronic illnesses.

History: Scurvy afflicted sailors for centuries. In 1747, James Lind showed citrus fruits could prevent symptoms, leading navies to adopt citrus rations and reduce mortality. Vitamin C was isolated in the 20th century, clarifying its essential role in human metabolism.

Diagnosis and treatment: diagnosis is largely clinical, supported by dietary history; low plasma ascorbate can confirm in uncertain cases. Treatment is prompt vitamin C supplementation, typically 100–300 mg daily, with rapid improvement within days and full recovery over weeks. Prevention relies on a diet rich in fruits and vegetables, including citrus, peppers, berries, leafy greens, and fortified foods. During voyages or in vulnerable populations, targeted supplementation is common to prevent recurrence.