Oral Pigmentation as a Sign of Addison’s Disease: A Brief Reappraisal

Alessandro Lanza1, 2, Inam Heulfe 3, Letizia Perillo 2, Antonio Dell’Ermo2, Nicola Cirillo *, 1
1 Regional Center on Craniofacial Malformations-MRI, 1st School of Medicine and Surgery, II University of Naples, 80138 Naples, Italy
2 Department of Oral Sciences, 1st School of Medicine and Surgery, II University of Naples, 80138 Naples, Italy
3 Bristol Dental Hospital, BS1 2LY Bristol, UK

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© 2009 Lanza et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Stomatology, Second University of Naples, Via Luigi de Crecchio, 7, 80138, Naples, Italy; Fax: +39 0815665500;


Pigmented lesions are frequently found in the oral cavity. Their overlapping clinical features should prompt the physician to carefully evaluate the patient’s medical history for a differential diagnosis. Oral pigmentations may represent physiological changes or be a manifestation of more serious diseases. Here, we describe a patient who was affected by brown maculae involving the perioral region and oral cavity. The diagnostic challenge of Addison’s disease along with a brief review on the topic is then presented.

Keywords: Addison’s disease, oral pigmentation, cortisol, ACTH.