๐ ็ธฝ็ฎ้ ๏ฝ ๐ ่ฑๆๅๆ๏ผๆฌ็ฏ๏ผ ๏ฝ ๐ ๅฎๆด็ฟป่ญฏ ๏ฝ โญ ็ฒพ่ฏ็ญ่จ
ADDISON DISEASE
ADDISON DISEASEย ย ICD-10: E27.1
โข Addison disease is a syndrome resulting from adrenocortical insufficiency.
โข It is insidious and is characterized by progressive generalized brown hyperpigmentation, slowly progressive weakness, fatigue, anorexia, nausea, and, frequently, GI symptoms (vomiting and diarrhea).
โข Suggestive laboratory changes include low serum sodium, high serum potassium, and elevation of the blood urea nitrogen. The diagnosis is confirmed by specific tests of adrenal insufficiency.
โข Skin: The patient may appear completely normal except for a generalized brown hyperpigmentation: (1) In areas where pigmentation normally occurs either habitually or UV induced such as around the eyes, face, and dorsa of the hands (Fig. 15-8A), nipples, in the linea nigra (abdomen), axillae, and anogenital areas in males and females. (2) In new areas: creases of palms (Fig. 15-8B), oral mucosa, (Fig. 15-8C) and bony prominences. Also in new scars following surgery.
โข This disease should be managed by an endocrinologist.
A B
C
FIGURE 15-8 โข Addison diseaseโ(A) Hyperpigmentation representing an accentuation of normal pigmentation of the hands of a patient with Addison disease. (B) Note accentuated pigmentation in the palmar creases. (C) Hyperpigmentation of the tongue in a patient with recently diagnosed Addison disease.