This patient with Addison's disease developed darkening of scars.

ADDISON'S DISEASE

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. Longitudinal melanonychia may develop and the linea nigra of women may darken.

Vitamin B12 Deficiency can cause hyperpigmentation of the skin and might be considered in the differential diagnosis. The AM cortisol is low.

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