Hyperpigmentation from Addison’s Disease

A 54 year old man with stage 4 chronic kidney disease presented with confusion, vomiting, and progressive hyperpigmentation of the skin and gingival mucosa. Laboratory findings revealed hypoglycemia, hyponatremia, hyperkalemia, and undetectable cortisol levels with elevated corticotropin, confirming primary adrenal insufficiency (Addison’s disease). Treatment with glucocorticoids and fludrocortisone resolved symptoms and reduced hyperpigmentation within 6 months. This case highlights the characteristic hyperpigmentation of Addison’s disease due to unchecked corticotropin stimulation of melanocytes.

A 54 year old man with stage 4 chronic kidney disease presented with confusion, vomiting, and progressive hyperpigmentation of the skin and gingival mucosa. Laboratory findings revealed hypoglycemia, hyponatremia, hyperkalemia, and undetectable cortisol levels with elevated corticotropin, confirming primary adrenal insufficiency (Addison’s disease). Treatment with glucocorticoids and fludrocortisone resolved symptoms and reduced hyperpigmentation within 6 months. This case highlights the characteristic hyperpigmentation of Addison’s disease due to unchecked corticotropin stimulation of melanocytes.