Addison Disease

Etiology
  • Adrenal insuficiency
  • Autoimmune
    • Bilateral adrenal hemorrhages during antiphospholipid syndrome
  • Infectious (TB)
  • Infiltrative (amyloidosis, hemochromatosis)
  • Granulomatous (sarcoidosis)
 
Clinical presentation
  • Skin
    • Melanoderma, due to stimulation of melanocyte function due to elevated plasma levels of ACTH and/or MSH
    • Acquired diffused or patchy bronze-brown appearance
    • More promenent: areas normally exposed, areas of friction, flexion creases, scars, nipples
      • Dorsal hands pigmented, no pigmentation on palms
      • Back of the tongue
      • Longitudinal nail bands
  • Sytemic
    • Fatigue, asthenia
    • Orthostatic hypotension