What skin finding is commonly associated with chronic adrenal insufficiency?

What skin finding is commonly associated with chronic adrenal insufficiency?

• A. Hyperpigmentation
• B. Jaundice
• C. Vitiligo
• D. Erythema nodosum

Answer: (A)

Hyperpigmentation is commonly seen with chronic adrenal insufficiency because cortisol is low and ACTH rises to compensate. ACTH shares a precursor with melanocyte-stimulating hormone, so high ACTH increases MSH activity and stimulates melanocytes, causing darkening of the skin and mucous membranes. This often shows up in areas like skin creases, palmar lines, and mucosal surfaces. Jaundice would suggest liver disease, vitiligo is autoimmune destruction of melanocytes not specifically tied to adrenal failure, and erythema nodosum is a panniculitis with different causes. So the darkened skin consistent with Addison’s disease is the typical finding.

Hyperpigmentation is commonly seen with chronic adrenal insufficiency because cortisol is low and ACTH rises to compensate. ACTH shares a precursor with melanocyte-stimulating hormone, so high ACTH increases MSH activity and stimulates melanocytes, causing darkening of the skin and mucous membranes. This often shows up in areas like skin creases, palmar lines, and mucosal surfaces. Jaundice would suggest liver disease, vitiligo is autoimmune destruction of melanocytes not specifically tied to adrenal failure, and erythema nodosum is a panniculitis with different causes. So the darkened skin consistent with Addison’s disease is the typical finding.