Melanoderma revealing primary antiphospholipid syndrome

Acute adrenal insufficiency is a rare complication of the primary antiphospholipid syndrome. We report a case of melanoderma of rapid onset revealing an addisonian crisis associated with primary antiphospholipid syndrome, which was associated with life-threatening hypercalcemia. Melanoderma does not belong to the clinical presentation of acute adrenal insufficiency. Its very rapid onset in our patient is probably due to her very high level of serum ACTH, in relation with her recent abortion.