SKIN HYPERPIGMENTATION

generalised pigmentation:

endocrine disease:

Addison's disease

hyperthyroidism

Nelson's syndrome [following adrenalectomy for Cushing's disease]

Cushing's syndrome [cases with raised ACTH]

other / miscellaneous:

normal in dark-skinned races or due to sun-tan

pregnancy (chloasma, linea nigra, etc.)

haemochromatosis ('bronze diabetes')

uraemia (sallow complexion)

heavy metal or arsenic poisoning

Peutz-Jeghers syndrome (peri-oral pigmentation)

Whipple's disease

visceral leishmaniasis

biliary cirrhosis

drugs:

diethylstilbestrol

steroids

nicotinic acid (niacin)

localised pigmentation:

café au lait patches:

neurofibromatosis

very late in SBE

acanthosis nigricans:

malignancy, esp. stomach (70%), colon and oesophagus

polycystic ovary syndrome

insulin-resistant diabetes mellitus

acromegaly

Prader-Willi syndrome

other:

following a severe dermatitis

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