Early diagnosis of Addison's disease; pigmentation as sole symptom

A diagnosis of primary adrenocortical insufficiency was made in a shapely, suntanned girl whose sole complaint was increasing pigmentation. Plasma cortisol was low in spite of markedly elevated levels of ACTH. Plasma cortisol, urinary 17-oxogenic steroids and urinary aldosterone did not respond to three days of ACTH stimulation. Addison's disease can be diagnosed and treated before development of anorexia, weight loss, weakness and other classical symptoms.