Hyperpigmentation, vitiligo, and Addison's disease

Abstract

Addison's disease is often autoimmune in nature. The autoimmune cause should be suspected when vitiligo occurs simultaneously with other findings of adrenal failure. Cortisol deficiency stimulates the production of a prohormone (POMC) which is then cleaved to form ACTH, β-MSH, and β-endorphin. It is believed that the released β-MSH then stimulates the production of melanin, causing the generalized melanosis characteristic of Addison's disease.