- Signs and Symptoms
- When to See a Doctor
What is Addison's disease?
In most cases, Addison’s is an autoimmune disease. Autoimmune disease occurs when the immune system doesn’t recognize the body’s own tissues and cells and begins to attack itself. In the case of Addison’s disease, the body specifically attacks the adrenals, causing damage to the glands.
The low level of cortisol triggers the release of another hormone called adrenocorticotropic hormone (ACTH). High ACTH leads to high levels of melanin, the chemical that gives skin its color and causes skin discoloration known as hyperpigmentation.
Signs and symptoms of Addison's disease in your skin
Addison’s disease usually progresses slowly and isn’t recognized until another illness or intense stress suddenly makes it worse. This can lead to a delayed diagnosis.
There are several Addison’s disease symptoms, which include:
The appearance of dark patches on the skin is a common symptom of Addison’s disease. The discoloration develops over a variety of areas, including:
- Elbows, knees, and joints
- Skin folds
- Mucous membranes in the mouth and nose
- Tongue and gums
- Genitals and rectum
Dark patches usually develop first in the mouth and gums, along with blue-black patches across the genitals and rectum, before they appear across the body.
Vitiligo is an autoimmune disease that causes the skin to lose its color. Smooth white patches of skin appear as the immune system destroys the skin cells that make melanin. It may also affect hair color and the hair in the inner ear.
People with one autoimmune disease are more at risk of developing another. Because most cases of Addison’s disease are autoimmune, people with Addison’s disease may also develop vitiligo.
Addison’s disease usually includes other symptoms like:
Causes of Addison's disease and its skin disorders
- Infections, including HIV, tuberculosis, and fungal infections
- Surgical removal of the glands
- Cancer in the glands
- Bleeding in the glands
- Genetic mutations
- Amyloidosis, excess protein buildup in organs
Suddenly stopping steroid medications can also cause Addison’s disease.
With chronic low levels of cortisol, the adrenocorticotropic hormone is released and stays high, which causes high levels of melanin. Dark skin patches can then develop.
When to see a doctor
If dark patches appear across the skin — or if they appear on the inside of the mouth and gums, nose, or genitals — it’s time to see a doctor or dermatologist. Changes in the skin should be investigated.
Diagnosis and tests for Addison's disease
To determine if you have Addison’s disease, your doctor may perform some of the following:
Your doctor may take your blood pressure, record your weight, and review your symptoms and history. They will also examine any dark patches on the skin.
ACTH stimulation test
This measures how the adrenal glands respond after taking a dose of adrenocorticotropic hormone. If the glands produce little cortisol after the medicine, they may not be working properly. A blood test will need to be done to measure cortisol levels.
Treatments for Addison's disease and its skin disorders
The main treatment is medication to replace adrenal hormones. Over time, the hyperpigmentation may gradually fade, allowing the skin to return to its normal color.
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National Institute of Diabetes and Digestive and Kidney Diseases: "Adrenal Insufficiency & Addison's Disease."
Online Journal of Dentistry & Oral Health: "Oral Pigmentation as a Sign of Addison's disease."
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UCLA Health: "Exogenous Adrenal Insufficiency."