Definition: Addison disease is a relatively uncommon insufficiency of adrenal corticosteroid hormones.
Etiology: Adrenal cortex destruction, usually caused by autoimmunity, infections, tumors, amyloidosis.
Clinical features: The oral manifestations are common and early, and present as diffuse or patchy dark brown pigmentation, due to melanin production (Figs. 96,97). The buccal mucosa, palate, lips, and gingiva are the most common sites of involvement.
Laboratory tests: Measurement of plasma adrenocorticotropic hormone (ACTH) and serum cortisol levels.
Differential diagnosis: Normal pigmentation, drug-induced pigmentation, Peutz-Jeghers syndrome.
Treatment: Steroid replacement.