Addisonian Hyperpigmentation as Oral Manifestation in Primary Adrenal Insufficiency – A Case Report

Abstract

Primary adrenal insufficiency is an endocrine disorder which is characterized by aldosterone and cortisol deficiency due to destruction of the adrenal cortex. The purpose of this case report is to present a rare case of 10-year-old child patient who reported with a chief complaint of pain in the upper left back tooth region of the jaw since a week and was diagnosed as Addison disease with hyperpigmentation of dorsal surface of the tongue, perioral structures and skin folds, nails and overall skin of the body. Oral manifestations along with endocrine issues play a crucial role in diagnosis & treatment planning of this disease. Dental infection can be a cause of adrenal crisis in patients with long term adrenal insufficiency, so paediatric dentists should be aware and a multidisciplinary approach is mandatory to ensure adequate medical and dental treatment in children. Limited number of case reports in literature suggest that adrenal crisis is a rare emergency condition in dentistry, and diagnosis is mandatory to rule out any condition before a dental surgical procedure