ADDISON'S DISEASE

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.

Clinical

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.

Diagnosis

The AM cortisol is elevated in Addison's disease.

Treatment

Referral to an endocrinologist is in order.

Additional Pictures

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

Diffuse Hyperpigmentation.
Addison's Disease

References

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

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