PMC4802555_01
Clinical presentation of scurvy. Perifollicular erythema, keratosis pilaris-like eruption, and corkscrew hairs on the upper back of a patient with vitamin C deficiency receiving vemurafenib for metastatic melanoma (inset with higher magnification of corkscrew hair surrounded by ink dots).
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After 4 months of treatment, systemic symptoms of severe fatigue, anorexia/dysgeusia, and arthralgias developed as did cutaneous manifestations including xerosis, a keratosis pilaris-like eruption on the trunk and extremities, and corkscrew hairs on the upper back, which were not present before vemurafenib therapy (Fig 1, Fig 2).
Histopathologic presentation of scurvy. Punch biopsy of a corkscrew hair shows a hair shaft cut on multiple cross sections with a rare eosinophil underlying the dermis. (Hematoxylin-eosin stain, original magnifications x4 and inset, x20.)
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After 4 months of treatment, systemic symptoms of severe fatigue, anorexia/dysgeusia, and arthralgias developed as did cutaneous manifestations including xerosis, a keratosis pilaris-like eruption on the trunk and extremities, and corkscrew hairs on the upper back, which were not present before vemurafenib therapy (Fig 1, Fig 2).
Resolution of corkscrew hairs and improvement in keratosis pilaris-like eruption after treatment with vitamin C.
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After 12 weeks, the keratosis pilaris-like eruption improved, and the corkscrew hairs resolved (Fig 3).