An elderly male patient presents with Hemorrhagic signs (petechiae), Hyperkeratosis of the hair follicles, Hypochondriasis, and Hematologic abnormalities. These "four Hs" are characteristic of deficiency of which of the following vitamins?

[Audio] This is a case of scurvy ( Vit C deficiency). The " four Hs" are characteristic of scurvy: hemorrhagic signs, hyperkeratosis of the hair follicles, hypochondriasis, and hematologic abnormalities. Perifollicular petechiae are the characteristic cutaneous finding. Among the Vit B deficiencies, we discussed pellagra, and it presents as a brown discoloration of the skin, especially in sun-exposed areas. Vit D deficiency may present with hair loss. And Vit K deficiency presents as bleeding/hemorrhage. None of these other Vit deficiencies present with hyperkeratosis of the hair follicles..

This is a case of scurvy (Vit C deficiency). The “four Hs” are characteristic of scurvy: hemorrhagic signs, hyperkeratosis of the hair follicles, hypochondriasis, and hematologic abnormalities. Perifollicular petechiae are the characteristic cutaneous finding. Among the Vit B deficiencies, we discussed pellagra, and it presents as a brown discoloration of the skin, especially in sun-exposed areas. Vit D deficiency may present with hair loss. And Vit K deficiency presents as bleeding/hemorrhage. None of these other Vit deficiencies present with hyperkeratosis of the hair follicles..

[Audio] This is a case of pellagra, characterized by the 3Ds: diarrhea, dementia, dermatitis. All the other options are not associated with diarrhea and dementia..

This is a case of pellagra, characterized by the 3Ds: diarrhea, dementia, dermatitis. All the other options are not associated with diarrhea and dementia..

[Audio] This is a case of Cushing's syndrome. None of the other choices would present with hypertrichosis, acne, and striae..

This is a case of Cushing’s syndrome. None of the other choices would present with hypertrichosis, acne, and striae..

[Audio] Pretibial myxedema are asymptomatic, red nodules that are usually present on the shins, ankles, or dorsum of the foot of patients with Graves' disease. Necrobiosis lipoidica are shiny, atrophic, red or yellow plaques with marked telangiectasia over their surface seen among patients with diabetes mellitus. Rheumatic nodules are painless nodules on the skin overlying bony prominences seen in patients with rheumatic fever. Tuberous xanthomas are firm, painless, red-yellow nodules that can coalesce to form multilobated tumors seen among patients with hyperlipidemias..

Pretibial myxedema are asymptomatic, red nodules that are usually present on the shins, ankles, or dorsum of the foot of patients with Graves’ disease. Necrobiosis lipoidica are s hiny , atrophic, red or yellow plaques with marked telangiectasia over their surface seen among patients with diabetes mellitus. Rheumatic nodules are painless nodules on the skin overlying bony prominences seen in patients with rheumatic fever. Tuberous xanthomas are firm, painless, red-yellow nodules that can coalesce to form multilobated tumors seen among patients with hyperlipidemias..

[Audio] This is a case of Peutz-Jeghers syndrome, which is autosomal dominant, due to mutations in a novel serine threonine kinase gene..

This is a case of Peutz-Jeghers syndrome, which is autosomal dominant, due to mutations in a novel serine threonine kinase gene..

[Audio] This is a case of psoriasis with psoriatic arthritis. All the other options do not present with erythematous plaques topped with thick, silvery scales, which is characteristic of psoriasis..

This is a case of psoriasis with psoriatic arthritis. All the other options do not present with erythematous plaques topped with thick, silvery scales, which is characteristic of psoriasis..

[Audio] This is a case of vitiligo, and diseases of the thyroid gland are the most frequently associated disorders, occurring in up to 30% of patients with vitiligo..

This is a case of vitiligo, and diseases of the thyroid gland are the most frequently associated disorders, occurring in up to 30% of patients with vitiligo..

[Audio] This is a case of HSP, which followed an URTI. All the other options do not present with non-blanching erythematous lesions on the LE. Rheumatic nodules – presents with nodules Pyoderma gangrenosum – ulcer SLE – erythematous, but blanching, papules and plaques.

This is a case of HSP, which followed an URTI. All the other options do not present with non-blanching erythematous lesions on the LE. Rheumatic nodules – presents with nodules Pyoderma gangrenosum – ulcer SLE – erythematous, but blanching, papules and plaques.