Addison’s Disease
Etiology • Adrenal cortical atrophy—85% idiopathic (?autoimmune) • Oral manifestations due to secondary melanocyte stimulation
by increased levels of adrenocorticotropic hormone (ACTH) or β-lipotropin
Clinical Presentation • Brown macular pigmentation of local or diffuse quality • Pigmentation usually seen in association with cutaneous
Etiology • Adrenal cortical atrophy—85% idiopathic (?autoimmune) • Oral manifestations due to secondary melanocyte stimulation
by increased levels of adrenocorticotropic hormone (ACTH) or β-lipotropin
Clinical Presentation • Brown macular pigmentation of local or diffuse quality • Pigmentation usually seen in association with cutaneous
bronzing, weakness, weight loss, salt craving, nausea, vomiting, hypotension
Diagnosis • Confirmation of hypoadrenocorticism by plasma ACTH levels
after challenge/stimulation • Biopsy of mucosa shows melanosis
Differential Diagnosis • Smoker’s melanosis • Physiologic/ethnic pigmentation • Heavy metal deposition/argyrosis • Medication-related pigmentation • Peutz-Jeghers syndrome
Treatment • Management of underlying adrenal insufficiency by cortico-
steroid replacement therapy
Prognosis • Good with replacement therapy