Vitamin C deficiency and leg ulcers. A case control study

Service de médecine vasculaire, groupe hospitalier Paris-Saint-Joseph, 185, rue Raymond-Losserand, Paris 75675 cedex 14, France.
Journal des Maladies Vasculaires (Impact Factor: 0.24). 05/2007; 32(2):96-9.
Source: PubMed


Vitamin C is a necessary cofactor for collagen synthesis. A deficiency of vitamin C results in the breakdown of connective tissue in and around the walls of blood vessels. The disease is thus characterized by poor healing of wounds. Chronic leg ulcers are defined as wounds that do not heal.
To investigate whether patients with chronic leg ulcers have vitamin C deficiency.
Case control study; vitamin C was assayed in peripheral blood samples of 42 consecutive patients with chronic leg ulcers and in 37 consecutive patients without chronic leg ulcers. Patients without leg ulcers had peripheral vascular disease, or hypertension, or connective disorders. Patients with diabetes, immunodepression (cancer, HIV infection, corticosteroid therapy) and aged under 65 years were excluded. Reference range for plasma vitamin C was above 26 micromol/l (normal levels, group I), hypovitaminosis C as 6-26 micromol/l (group II) and concentrations<6 micromol/l as scurvy (group III).
Mean age was 77.2 years in the ulcers group and 73.8 in the control group (NS), mean weight 73.1 kg in the ulcers group and 67.5 kg in the control group (NS). Smoking was more frequent in the control group (P<0.001). Mean vitamin C levels were lower in the leg ulcers group: 23.9 vs 33.8 micromol/l (P<0.003). Normal levels of vitamin C (group I) were more frequent in the control group: 78.4 vs 50% (P<0.01). Hypovitaminosis C (group II) was more frequent in the leg ulcers group: 23.8 vs 16.2% (P<0.01). Scurvy was more frequent in the leg ulcers group: 26.2 vs 5.4% (P<0.01). C reactive protein levels were higher in the leg ulcers group: 31.8 vs 9.3 mg (P=0.002) and albumin levels were lower in the leg ulcers group: 25 vs 38 g/l (P=0.01) [retrospective data].
Patients with chronic leg ulcers have lower levels of vitamin C than patients without leg ulcers, although smoking was more frequent in patients without leg ulcers. The question is whether vitamin C deficiency is a cofactor of impaired healing or is a simple marker of poor healing? It would be interesting to conduct a randomized controlled study about treatment of chronic leg ulcers with vitamin C.

49 Reads
  • [Show abstract] [Hide abstract]
    ABSTRACT: Chronic wounds occur in 1-2% of the population. After the age of 80 the incidence raises up to 4-5%. Leg ulcers are the most frequent diagnosed chronic wound. In this most often affected age group malnutrition develops more frequently compared to the total population. The combined presence of chronic wounds and malnutrition suggests a potential causative connection. In this clinical investigation, data evaluating the nutritional status in patients with chronic leg ulcers, derived from clinical examination, medical history and laboratory tests was analyzed for the first time for a German patient collective. Over a time period of one year we evaluated 41 patients for body mass index, diabetes mellitus, restricted mobility, diet, nicotine and alcohol use, and blood levels of vitamins, trace elements, lipids and HbA1c. We further employed the MNA-questionnaire for malnutrition. We rarely found deficiencies but often improper nutritional practices. Thus we consider that it important to evaluate nutritional status even in obese patients with leg ulcers and poorly healing wounds.
    No preview · Article · Apr 2008 · Der Hautarzt
  • [Show abstract] [Hide abstract]
    ABSTRACT: Chlamydia trachomatis is the most common bacterial cause of cervicitis. The aim of this randomised, double-blind trial was to compare the effect of vitamin C on dyspareunia and vaginal discharge in women receiving doxycycline and triple sulfa for chlamydial cervicitis. Eighty women with increased anti-C. trachomatis IgM, reporting abnormal vaginal discharge and dyspareunia, demonstrating signs of cervical oedema and erythema and friability of cervix were included. Thirty-nine women received doxycycline capsules 100 mg twice daily plus triple sulfa vaginal cream once daily for ten days, and 41 received doxycycline capsules 100 mg twice-daily and triple sulfa vaginal cream once daily plus vitamin C tablets 250 mg once daily for ten days. Women were evaluated at follow-up visit, eleventh day, following completion of intervention. The effect of treatment was assessed regarding clinical criteria (presence of endocervical mucopus and cervical severity score) and presence of dyspareunia. Statistical analysis was carried out using spss version 11.5. The mean age of women was 30.6 +/- 8.4 years. There was no relationship between demographics and dyspareunia and discharge (P > 0.05). There was statistically significant difference between the effect of 'doxycycline plus triple sulfa' and 'doxycycline, triple sulfa plus vitamin C' on discharge and dyspareunia (P = 0.005, P < 0.001, respectively). Most frequently reported drug-related adverse event in both groups was heartburn. Adding vitamin C to doxycycline and triple sulfa was more efficient than standard regimen (doxycycline and triple sulfa without vitamin C) in treating chlamydial cervicitis.
    No preview · Article · Oct 2009 · Australian and New Zealand Journal of Obstetrics and Gynaecology
  • [Show abstract] [Hide abstract]
    ABSTRACT: One of the defining characteristics of dermatology is wide array of procedures that are performed on the skin. Whether for diagnostic or treatment purposes, dermatologic procedures are an important constituent contributing to the personality of this specialty. Dermatologic surgery is one of the most important of these procedures and although not common, adverse events can result, which are troublesome both for the patient and the physician. An appropriate knowledge of how to prevent such undesirable occurrences is mandatory for any physician wishing to engage in dermatologic surgery. It is hoped that this chapter will contribute to this important body of knowledge.
    No preview · Chapter · Dec 2009
Show more