What are the symptoms of Addison's disease
The author, whose name is in the name of the disease, saidthe most vivid detail ( "bronze skin") in the clinical picture of the disease caused by chronic insufficiency of the adrenal cortex. Common symptoms of this disease are well known: slowly developing general weakness, fatigue, fatigue, weakness, loss of appetite, nausea, vomiting, diarrhea, decreased blood pressure, reduction of gastric acid secretion, blood glucose levels, basal metabolism, and others.
Wherein hyperpigmentation caused by increasedmelanin content and occurs in most patients. Skin pigmentation in Addison's disease may have the most diverse cast. The most common golden-brown, bronze paint, hence the name of the disease. Sometimes pigmentation is muddy brown, earthy, lemon yellow hue or color reminiscent of sun tanning.
It is characteristic that even a light tan preservesthese patients until the new holiday season. The development of pigmentation may start with a short-term inflammation of the skin, and then remains stable giperpigmenti-ment spot. In clinical practice, this property is used for diagnostic purposes: impose a yellow card in the unaltered skin, and a few days after this there is a growing painting. The spots can appear anywhere on the body but most often pigmented exposed skin, place constant pressure and friction (lower back, knees, elbows), large folds of skin.
Characterized by increased pigmentation of palms foldsand soles, while the rest of the surface is not pigmented, Noteworthy increased pigmentation in a physiologically hyperpigmented areas (nipples pectoral glands, genitals). Frequently observed in the postoperative hyperpigmentation and other scars, on the ground of the former piodermicheskih injuries and lesions. In patients with Addison's disease is enhanced pigmentation and melanocytic nevi marked the emergence of new ones. A number of patients hair get darker.
Pigmentation of the mucous membrane of the oral cavity -an important diagnostic sign of Addison's disease. Often pigmented mucous membranes of the rectum and the vagina, much less - the conjunctiva of the eye. It is very rare form of pigmentation disorders in patients with Addison's disease include vitiligo, when the background of hyper-pigmentation develop depigmented patches.
Diagnosis of Addison's disease
Diagnosis is based on clinical signs listed above.
Differential diagnosis should be done withchanges in pigmentation due to sun tanning, thyrotoxicosis, pernicious anemia, connective tissue, pellagra, chronic poisoning by heavy metals, X-rays, liver cirrhosis, cancers, age-papillary skin dystrophy, melanodermicheskoy form planus, purple and others. The mechanism of hyperpigmentation in disease Addison is presented as a consequence of reducing the production of corticosteroid hormones, leading to increased generation of ACTH (adrenocorticotropic hormone), and along with it, and melanocyte-stimulating hormone.
Insufficient ascorbic acidAddison's disease when the body suggests the similarity of the pathogenesis of the pigmentation disorders in this disease and C-vitamin deficiency. High blood copper content of Addison's disease patients can probably also increase the activity of tyrosinase and lead to increased synthesis of melanin.