Pigmentary disorders: Addison disease: practice question

A Dermatology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Dermatology · Pigmentary disorders: Addison disease

Sample item

A woman with fatigue, hypotension and hyperpigmentation of the palmar creases, buccal mucosa and scars has low cortisol. What explains the pigmentation?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Excess ACTH and related POMC peptides stimulating melanocytes

In primary adrenal failure, loss of negative feedback increases ACTH release from POMC, and the alpha-MSH fragment stimulates melanocytes via MC1R. Pressure areas, creases, scars and mucosa darken.

Option by option

  • A. Excess cortisol

    Cortisol is low, not high.

  • B. Increased insulin

    Insulin does not cause this pigmentation.

  • C. Excess ACTH and related POMC peptides stimulating melanocytes (correct)

    Correct. High ACTH and POMC products darken the skin.

  • D. Deficiency of aldosterone directly

    Aldosterone deficiency affects electrolytes and blood pressure, not pigment.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is C, Excess ACTH and related POMC peptides stimulating melanocytes. In primary adrenal failure, loss of negative feedback increases ACTH release from POMC, and the alpha-MSH fragment stimulates melanocytes via MC1R.

Why is "Excess cortisol" not the answer?

Cortisol is low, not high.

Why is "Increased insulin" not the answer?

Insulin does not cause this pigmentation.

Why is "Deficiency of aldosterone directly" not the answer?

Aldosterone deficiency affects electrolytes and blood pressure, not pigment.

What concept does this question test?

It tests Pigmentary disorders: Addison disease in Dermatology. Pressure areas, creases, scars and mucosa darken.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Pigmentary disorders: Addison disease?

Learn each condition by its primary lesion, site and signature sign. Then use the flashcards and the other Dermatology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.