Not a make-up, but an alarm signal of a new onset of Addison's disease

Abstract

Case report: A 52 year old woman had an appointment at the Dermatology Department for a previous diagnosis of melasma. She was seen in October and her pigmentation had appeared somewhere during summer. She did not recall any drug intake, she denied sun exposure in the recent past, and she was a social employee working indoor.At the clinical examination intense hyperpigmentation around the eyes was noted, In contrast with the rest of the skin of normal aspect. The pigmentation was very well demarcated with no symptoms associated.Our first gesture was to ask the lady to use a cotton swab to clear the make-up, obviously with no results. Local trauma and melasma were excluded from the beginning.A minutious clinical examination was performed, but remained unremarkable; no history of fatigue or anxiety, no sleep disturbance, no loose of appetite or weight loss, no complaints. Blood pressure and pulse were normal.Routine laboratory investigations were within normal range including fasting blood, serum urea, creatinine and electrolyte; anti-HIV, anti hepatitis C virus hepatitis B surface antigen (HCV ,HBsAg) factors were negative.