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7 out of 8

Regarding Addisonian pigmentation, all are true EXCEPT: (AIIMS May 2009)

A Involves moles and scars

B Involves palmer creases

C Does not involve oral mucosa

D Decreased fibrosis

Ans. C

Does not involve oral mucosa

This increased pigmentation is diffuse but may be accentuated in the

1). Palmer crease

2). Sites of friction & pressure areas - Knuckles, elbows, knees, nail beds

3). Scars

4). Oral mucosa, gums & conjunctival

5). Areolae of nipples

Important Points:

1). Increase in ACTH occurs only in primary Addison’s disease.

2). It is not seen in secondary Addison disease as it is caused due to decrease in ACTH.

3). Therefore, pigmentation cannot occur in secondary Addison's disease.

Extra Edge:

1). Primary Addison’s disease both aldosterone and glucocorticoid are deficient,

2). In secondary Addison’s disease only glucocorticoid deficiency is seen.