Addison Disease Oral Pigmentation — NDEB AFK MCQ

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HardOral MedicineAddison Disease Oral PigmentationNDEB AFK

Addison disease (primary adrenal insufficiency) is characterised by which oral manifestation?

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Correct answer: E — Diffuse melanotic pigmentation of the oral mucosa

Addison disease causes diffuse melanotic (brown/bronze) hyperpigmentation of the oral mucosa (particularly the buccal mucosa, lips, gingiva, and palate) due to increased ACTH secretion from the anterior pituitary. ACTH shares a precursor molecule (POMC) with melanocyte-stimulating hormone (MSH), so elevated ACTH stimulates melanin production. This oral pigmentation may be the first clinical sign of undiagnosed Addison disease and should prompt investigation (serum cortisol, ACTH stimulation test). Other features include fatigue, hypotension, hypoglycaemia, and electrolyte imbalance.

Reference: Neville – Oral and Maxillofacial Pathology, 4th ed., 2016