Addison Disease.

Addison disease is a clinical syndrome characterized by salt-wasting and skin hyperpigmentation, associated with adrenal deficiency and consequent inadequate secretion of corticosteroid and androgenic hormones. In the Western world, Addison disease is usually autoimmune in etiology.

Hyperpigmentation is the most striking cutaneous sign of patients with chronic Addison disease. The hyperpigmentation is diffuse and occurs preferentially on sun-exposed areas (face, neck, hands), on sites of trauma, scars, or chronic pressure (knees, spine, knuckles, elbows, shoulders), in the palmar creases and on nipples, areolae, axillae, perineum, and genitalia. It is discussed in Chap.