General dermatology and dermatology in primary healthcare

Primary adrenal insufficiency (PAI), when the adrenal glands fail to secrete sufficient quantities of glucocorticoid and mineralocorticoid hormones, can be life threatening. Symptoms are often nonspecific, and hyperpigmentation may be crucial for reaching a diagnosis. We describe a patient with PAI for whom hyperpigmentation was the key feature leading to diagnosis and treatment.