By Gary M. White, MD

Addison's Disease Hyperpigmented palm on left compared with normal palm on right. Courtesy Dr. Kaess

Addison's disease (AD) is the result of primary adrenal insufficiency. Systemic symptoms include weight loss, anorexia, and fatigue. More acute symptoms include hypotension, fever, and hypoglycemia.


Progressive hyperpigmentation diffusely, but with accentuation in areas that are normally more darkly pigmented is characteristic. Darker pigmentation of the photoexposed skin, of the nipples and areola, of scars, of the oral mucosa (e.g., tongue and lips), and of the periorbital and anogenital areas may occur in patients with adrenocortical insufficiency or Addison's disease. Longitudinal melanonychia may develop [CED 2013;38;689] and the linea nigra of women may darken.


The AM cortisol is elevated in Addison's disease.


Referral to an endocrinologist is in order.

Additional Pictures

Hyperpigmentation of scars in Addison's disease.
Addison's Disease

Diffuse Hyperpigmentation.
Addison's Disease


Indian J Endocrinol Metab. 2012 May-Jun; 16(3): 481–482


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