title: Addison's disease, diffuse skin, and mucosal hyperpigmenation with subtle "flu-like" symptoms--a report of two cases.
abstract: Addison's disease, or chronic adrenocortical insufficiency, is the overproduction of adrenocorticotropic hormone by the pituitary gland as a compensatory mechanism for decreased cortisol production by the adrenal glands. Classically, patients affected with Addison's disease develop weakness, anorexia, electrolyte imbalances: decreased sodium and chloride with increased serum potassium resulting in hypotension, and hyperpigmentation of the skin and mucous membranes. Herein this case report, we focus on the subtle findings of diffuse hyperpigmentation and intermittent but repetitive "flu-like" symptoms in two patients to correctly identify the diagnosis of Addison's disease effectively and efficiently.
authors.affiliation: Department of Dermatology and Cutaneous Surgery, Division of Pediatric Dermatology, University of Miami, Miller School of Medicine, Miami, Florida, USA. cynthiajburk@yahoo.com
authors.forename: Cynthia J
authors.initials: CJ
authors.lastname: Burk
authors.forename: Giovanna
authors.initials: G
authors.lastname: Ciocca
authors.forename: Candrice R
authors.initials: CR
authors.lastname: Heath
authors.forename: Anna
authors.initials: A
authors.lastname: Duarte
authors.forename: Magdalene
authors.initials: M
authors.lastname: Dohil
authors.forename: Elizabeth Alvarez
authors.initials: EA
authors.lastname: Connelly
mesh_terms: D000224:Addison Disease / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D000293:Adolescent; D003907:Dexamethasone / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D005438:Fludrocortisone / Q000627:therapeutic use; D006801:Humans; D006854:Hydrocortisone / Q000097:blood
chemical_list: D003907:Dexamethasone; D005438:Fludrocortisone; D006854:Hydrocortisone