Three Unusual Pigmentary Syndromes

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Abstract
We have had the opportunity to examine directly patients with a variety of pigmentary anomalies. In addition, we have corresponded with physicians whose patients have disorders of pigmentation. In the present report 2 unusual types of hyperpigmentation and one of hypopigmentation will be described. Hyperpigmentation There are many causes of hyperpigmentation. The present discussion will be confined to hyperpigmentation associated with hyperactivity of the pituitary gland. In Addison's disease or adrenal cortical insufficiency, a characteristic kind of hyperpigmentation develops. Darkening occurs in the exposed areas, body folds, mucous membranes, and sites of recent trauma. There is good evidence that this hyperpigmentation results from increased release of melanocytestimulating hormone (MSH) from the intermediate lobe of the pituitary gland.1,2 The following experiments support this concept: administration of homogenous MSH preparations to man produced skin darkening; urinary excretion of MSH was increased in patients with adrenal cortical insufficiency, and MSH was increased

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