Chulalongkorn Medical Journal


Addison’s disease, also known as primary adrenal insufficiency, can manifest asgeneralized mucocutaneous hyperpigmentation. The common causes of Addison’s disease indeveloping countries are mycobacterium and fungal infections. Histoplasma capsulatum is adimorphic fungi, which may disseminate to the adrenal glands and skin, causing Addison’sdisease and skin lesions such as macules, acneiform pustular eruptions, erythematous papules,nodules, keratotic plaques with or without crust and mucosal ulceration.We present a case of a 45-year-old male with Addisonian pigmentation for one yeartogether with multiple skin-colored flat top papules on both inguinal areas 3 months earlier.Cutaneous lesions were carefully physical examined might easily lead to the cause of Addison’sdisease by using biopsy from skin lesions which found histoplasma capsulatum same asfound in fine needle aspiration (FNA) from right adrenal mass.

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