{"id":1100,"date":"2020-05-17T14:08:09","date_gmt":"2020-05-17T21:08:09","guid":{"rendered":"https:\/\/up.physicaldiagnosispdx.com\/up\/?page_id=1100"},"modified":"2020-12-25T00:49:01","modified_gmt":"2020-12-25T08:49:01","slug":"hyperpigmentation","status":"publish","type":"page","link":"https:\/\/up.physicaldiagnosispdx.com\/up\/endocrinology-multimedia\/hyperpigmentation\/","title":{"rendered":"Hyperpigmentation"},"content":{"rendered":"<div class=\"wpb-content-wrapper\">[vc_row css=&#8221;.vc_custom_1591995390219{background-color: #fff9f9 !important;}&#8221;][vc_column][vc_column_text]<span style=\"font-size: 14pt;\">Hyperpigmentation can be a sign of ACTH-independent (primary) adrenal insufficiency. High levels of ACTH found in these patients stimulate the melanocortin-1 receptor in the skin, resulting in hyperpigmentation. It tends to first occur in areas of the skin under pressure, including elbows, knuckles, palmar creases, lips, and buccal mucosa.<\/span><br \/>\n<figure id=\"attachment_1658\" aria-describedby=\"caption-attachment-1658\" style=\"width: 150px\" class=\"wp-caption alignleft\"><a href=\"https:\/\/up.physicaldiagnosispdx.com\/up\/endocrinology\/endocrinology-2\/#Hyperpigmentation\"><img decoding=\"async\" loading=\"lazy\" class=\"wp-image-1658 size-thumbnail\" src=\"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/iconfinder_3_1250308-150x150.png\" alt=\"\" width=\"150\" height=\"150\" srcset=\"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/iconfinder_3_1250308-150x150.png 150w, https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/iconfinder_3_1250308-300x300.png 300w, https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/iconfinder_3_1250308.png 512w\" sizes=\"auto, (max-width: 150px) 100vw, 150px\" \/><\/a><figcaption id=\"caption-attachment-1658\" class=\"wp-caption-text\">&nbsp;<\/figcaption><\/figure>[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text]\n<h1>Patient 1:<\/h1>\n<p><span style=\"font-size: 14pt;\">This is a previously healthy middle-aged man who presented with severe abdominal pain, hypotension, and colitis on cross-sectional imaging. He described many years of skin darkening, fatigue, and abdominal pain. After the history and examination, the patient was suspected to have adrenal crisis, which was confirmed with biochemical testing. Prior to this presentation, the patient had seen several doctors over the years, including a dermatologist, but he remained undiagnosed.<\/span>[\/vc_column_text][\/vc_column][\/vc_row][vc_row css=&#8221;.vc_custom_1591995413907{background-color: #dcd9dd !important;}&#8221;][vc_column width=&#8221;1\/4&#8243;][\/vc_column][vc_column width=&#8221;3\/4&#8243;][vc_column_text]<div id='gallery-1' class='gallery galleryid-1100 gallery-columns-3 gallery-size-medium'><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon portrait'>\n\t\t\t\t<a href='https:\/\/up.physicaldiagnosispdx.com\/up\/endocrinology-multimedia\/hyperpigmentation\/endocrinology_adrenal-insufficiency_hyperpigmentation_hyperpigmentation_ai\/'><img loading=\"lazy\" decoding=\"async\" width=\"225\" height=\"300\" src=\"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/Endocrinology_Adrenal-Insufficiency_Hyperpigmentation_Hyperpigmentation_AI-scaled-wpp1591076148551-225x300.jpg\" class=\"attachment-medium size-medium\" alt=\"\" srcset=\"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/Endocrinology_Adrenal-Insufficiency_Hyperpigmentation_Hyperpigmentation_AI-scaled-wpp1591076148551-225x300.jpg 225w, https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/Endocrinology_Adrenal-Insufficiency_Hyperpigmentation_Hyperpigmentation_AI-scaled-wpp1591076148551.jpg 540w\" sizes=\"auto, (max-width: 225px) 100vw, 225px\" \/><\/a>\n\t\t\t<\/div><\/figure><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon portrait'>\n\t\t\t\t<a href='https:\/\/up.physicaldiagnosispdx.com\/up\/endocrinology-multimedia\/hyperpigmentation\/endocrinology_adrenal-insufficiency_hyperpigmentation_figure_7-1a\/'><img loading=\"lazy\" decoding=\"async\" width=\"169\" height=\"300\" src=\"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/Endocrinology_Adrenal-Insufficiency_Hyperpigmentation_Figure_7-1A-wpp1591076176334-169x300.png\" class=\"attachment-medium size-medium\" alt=\"\" srcset=\"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/Endocrinology_Adrenal-Insufficiency_Hyperpigmentation_Figure_7-1A-wpp1591076176334-169x300.png 169w, https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/Endocrinology_Adrenal-Insufficiency_Hyperpigmentation_Figure_7-1A-wpp1591076176334.png 405w\" sizes=\"auto, (max-width: 169px) 100vw, 169px\" \/><\/a>\n\t\t\t<\/div><\/figure>\n\t\t<\/div>\n[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text]\n<h1>Patient 2:<\/h1>\n<p><span style=\"font-size: 14pt;\">This is a previously healthy young woman who was diagnosed with primary adrenal insufficiency. Hyperpigmentation can be seen over the knuckles. The astute observer will also note that the patient has about 3 mm of fingernail growth since she last painted her nails. Fingernails grow at rate of approximately 1 mm per week, and so the illness was predicted to have began approximately 3 weeks prior to presentation, which was corroborated by the patient.<\/span>[\/vc_column_text][\/vc_column][\/vc_row][vc_row css=&#8221;.vc_custom_1591995429099{background-color: #dcd9dd !important;}&#8221;][vc_column width=&#8221;1\/4&#8243;][vc_column_text][\/vc_column_text][\/vc_column][vc_column width=&#8221;1\/2&#8243;][vc_column_text]<div id='gallery-2' class='gallery galleryid-1100 gallery-columns-3 gallery-size-medium'><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon portrait'>\n\t\t\t\t<a href='https:\/\/up.physicaldiagnosispdx.com\/up\/endocrinology_adrenal-insufficiency_hyperpigmentation_hyperpigmentation_primary_ai-2\/'><img loading=\"lazy\" decoding=\"async\" width=\"258\" height=\"300\" src=\"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/Endocrinology_Adrenal-Insufficiency_Hyperpigmentation_Hyperpigmentation_Primary_AI-1-258x300.jpg\" class=\"attachment-medium size-medium\" alt=\"\" srcset=\"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/Endocrinology_Adrenal-Insufficiency_Hyperpigmentation_Hyperpigmentation_Primary_AI-1-258x300.jpg 258w, https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/Endocrinology_Adrenal-Insufficiency_Hyperpigmentation_Hyperpigmentation_Primary_AI-1-879x1024.jpg 879w, https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/Endocrinology_Adrenal-Insufficiency_Hyperpigmentation_Hyperpigmentation_Primary_AI-1-768x895.jpg 768w, https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/Endocrinology_Adrenal-Insufficiency_Hyperpigmentation_Hyperpigmentation_Primary_AI-1-1319x1536.jpg 1319w, https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/Endocrinology_Adrenal-Insufficiency_Hyperpigmentation_Hyperpigmentation_Primary_AI-1-1758x2048.jpg 1758w\" sizes=\"auto, (max-width: 258px) 100vw, 258px\" \/><\/a>\n\t\t\t<\/div><\/figure>\n\t\t<\/div>\n[\/vc_column_text][\/vc_column][vc_column width=&#8221;1\/4&#8243;][\/vc_column][\/vc_row]\n<\/div>","protected":false},"excerpt":{"rendered":"<p>[vc_row css=&#8221;.vc_custom_1591995390219{background-color: #fff9f9 !important;}&#8221;][vc_column][vc_column_text]Hyperpigmentation can be a sign of ACTH-independent (primary) adrenal insufficiency. High levels of ACTH found in these patients stimulate the melanocortin-1 receptor in the skin, resulting in hyperpigmentation. It tends to first occur in areas of the skin under pressure, including elbows, knuckles, palmar creases, lips, and<\/p>\n","protected":false},"author":9,"featured_media":0,"parent":1047,"menu_order":0,"comment_status":"open","ping_status":"closed","template":"page-templates\/page_PDXPDX-full-width.php","meta":{"nf_dc_page":"","_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"class_list":["post-1100","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-json\/wp\/v2\/pages\/1100","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-json\/wp\/v2\/users\/9"}],"replies":[{"embeddable":true,"href":"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-json\/wp\/v2\/comments?post=1100"}],"version-history":[{"count":0,"href":"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-json\/wp\/v2\/pages\/1100\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-json\/wp\/v2\/pages\/1047"}],"wp:attachment":[{"href":"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-json\/wp\/v2\/media?parent=1100"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}