A patient presents with spontaneous gingival bleeding, perifollicular hemorrhages, and corkscrew hairs on the skin. Which condition is most likely causing the gingival manifestations?

The combination of spontaneous gingival bleeding, perifollicular hemorrhages, and corkscrew (coiled) hairs is pathognomonic of scurvy (vitamin C deficiency). Ascorbic acid (vitamin C) is essential for collagen synthesis. Without it, capillary walls and connective tissues become fragile, leading to spontaneous bleeding from the gingiva, skin, and other tissues. Gingival changes in scurvy include swollen, hemorrhagic, purple-red gingiva that bleeds spontaneously — but NOT gingival enlargement. Vitamin C deficiency does NOT cause gingival overgrowth (that is Phenytoin). Phenytoin causes firm gingival overgrowth without the systemic hemorrhagic signs.