{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T05:44:57Z","timestamp":1788327897296,"version":"build-2803163510"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Skin colour usually depends upon melanin, haemoglobin, and carotenoids. Pigmentary disorders indicate an increased amount of melanin, leading to a darker colour of the skin, called hypermelanosis. Addison\u2019s disease is a rare endocrinal disorder with severe oral and systemic manifestations. Any form of diffuse skin hyper-pigmentation which is more pronounced on sun-exposed areas mimics Addison\u2019s disease and is called Addisonian pigmentation. Pigmentation often precedes other manifestations by months to years and hence can lead to early diagnosis and can prevent life-threatening adrenal crisis. The most common cause of adrenal insufficiency in developing countries is tuberculosis. A similar pattern of pigmentation has been reported in Cushing\u2019s syndrome, ectopic ACTH-producing tumours, vitamin B12 deficiency, and thyrotoxicosis. Addisonian pigmentation can be a manifestation of multiple systemic diseases; hence, an inter-disciplinary approach is needed with extensive clinical and laboratory evaluation. It is not merely a cosmetic concern. Not much data are available in the literature regarding this entity. This brief review serves as an important source for clinicians to stay up-to-date regarding the history, clinical presentation, differential diagnosis, and management of this entity.<\/jats:p>","DOI":"10.4103\/ijd.ijd_234_23","type":"journal-article","created":{"date-parts":[[2024,10,30]],"date-time":"2024-10-30T11:48:51Z","timestamp":1730288931000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Addisonian Pigmentation \u2013 The Great Mimicker \u2013 A Review"],"prefix":"10.4103","author":[{"given":"Damini","family":"Verma","sequence":"first","affiliation":[{"name":"From the Department of Dermatology, Lady Hardinge Medical College and Hospitals, Connaught Place, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rashmi","family":"Sarkar","sequence":"additional","affiliation":[{"name":"From the Department of Dermatology, Lady Hardinge Medical College and Hospitals, Connaught Place, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vibhu","family":"Mendiratta","sequence":"additional","affiliation":[{"name":"From the Department of Dermatology, Lady Hardinge Medical College and Hospitals, Connaught Place, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amol","family":"Srivastava","sequence":"additional","affiliation":[{"name":"Department of Radiology, Institute of Liver and Biliary Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,9,18]]},"reference":[{"key":"R1-20250114","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1590\/S0365-05962013000100009","article-title":"Mechanisms regulating melanogenesis","volume":"88","author":"Videira","year":"2013","journal-title":"An Bras 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