[Increasing pigmentation in Schmidt syndrome (polyglandular autoimmune syndrome type II].

Abstract

An 18-year old man presented with increasing pigmentation in multiple nevi as well as so-called "eruptive nevi" over a 24 month period. The first excisional biopsy was from a plantar nevus which showed melanocytic hyperplasia. Following excisions of both hyperpigmented and newly appearing nevi showed only increased pigmentation. Two years after the first examination Addison-like hyperpigmentation was noticed in typical locations. Both Addison disease and Hashimoto thyroiditis were then confirmed by elevated serum levels of ACTH, TSH, and decreased levels of cortisol and L-thyroxine. This confirmed the diagnosis of Schmidt syndrome as part of polyglandular autoimmune disease (PGAS) type II. After another 18 months of treatment with hormone substitution of L-thyroxine and hydrocortisone, the hyperpigmentation resolved and the hyperpigmented nevi decreased in number.

• Authors: S Sünkel, A Wichmann-Hesse, R Gärtner, G Hesse
• Journal: Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete (Hautarzt) Vol. 52 Issue 10 Pt 2 Pg. 974-6 (Oct 2001) ISSN: 0017-8470 [Print] Germany
• Vernacular Title: Pigmentvermehrung bei Schmidt-Syndrom (polyglanduläres Autoimmunsyndrom Typ II).
• PMID: 11715397 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Anti-Inflammatory Agents
• Thyroxine
• Fludrocortisone
• Hydrocortisone

Topics

• Addison Disease (complications)
• Adolescent
• Anti-Inflammatory Agents (administration & dosage, therapeutic use)
• Biopsy
• Drug Therapy, Combination
• Fludrocortisone (administration & dosage, therapeutic use)
• Follow-Up Studies
• Humans
• Hydrocortisone (administration & dosage, therapeutic use)
• Hyperpigmentation (drug therapy, pathology)
• Male
• Nevus, Pigmented (complications, pathology)
• Polyendocrinopathies, Autoimmune
• Skin (pathology)
• Thyroiditis, Autoimmune (complications)
• Thyroxine (administration & dosage, therapeutic use)
• Time Factors