title: Addisonian-Like Hyperpigmentation as an Indicator of Uncontrolled Congenital Adrenal Hyperplasia.
abstract: A 20-year-old man of Indo-Malaysian ancestry presented with a complaint of increased facial pigmentation that he first noticed at age 13. He had congenital adrenal hyperplasia (21-hydroxylase deficiency, salt-wasting variant; OMIM 201910), diagnosed during infancy. Glucocorticoid and mineralocorticoid therapy was started at that time, but he had several episodes of salt craving during adolescence. During the past 7 years, the degree of facial pigmentation waxed and waned but never returned to baseline of early adolescence. Progressive skin darkening was also observed in annual family photos, which also showed a vast difference in skin tones between the patient and other members of his immediate family.
authors.affiliation: Department of Dermatology, George Washington University School of Medicine, Washington DC.
authors.forename: Forum B
authors.initials: FB
authors.lastname: Patel
authors.affiliation: Department of Dermatology, George Washington University School of Medicine, Washington DC; sab0403@yahoo.com.
authors.forename: Sabrina A
authors.initials: SA
authors.lastname: Newman
authors.affiliation: Georgetown University School of Medicine, Washington DC.
authors.forename: Scott A
authors.initials: SA
authors.lastname: Norton
mesh_terms: D000312:Adrenal Hyperplasia, Congenital / Q000150:complications* / Q000188:drug therapy; D005148:Facial Dermatoses / Q000209:etiology*; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D017495:Hyperpigmentation / Q000209:etiology*; D008297:Male; D055815:Young Adult
chemical_list: D005938:Glucocorticoids