Endocrine

Question 1

What is addisons disease? Cutaneous findings?

Answer 1

Cortisol deficiency. Diffuse hyperpigmentation secondary to ACTH secretion, (worst sunexposed sites, sites of trauma), palmar crease darkening, darkening of existing naevi, eruptive onset multiple naevi, reduced ambisexual hair, fibrosis and calcification of cartilage

Question 2

Types of acanthosis nigricans.

Answer 2

Obesity
Paraneoplastic
Metabolic
Endocrinopathies (cushings)
Benign
Medication (steroids, oestrogen, insulin, niacin, testosterone, protease inhibitors, fusidic acid)

Question 3

How to treat acanthosis nigricans?

Answer 3

Consider underlying conditions (diabetes, serum cortisol)
Treat as appropriate in combination w GP (eg consider metformin, weightless).
Topical retinoid, keratolytics (ammonium lactate), calcipotriene