In contrast to Addison’s disease, a triad is characteristic of pellagra: dermatitis, previous pigmentation, acquired dementia (dementia), and diarrhea. When pellagra pigmentation is observed only on the open parts of the body (hands, face, neck).
In systemic scleroderma, in contrast to Addison’s disease, there is a widespread, dense swelling of the skin or its thickening and atrophy. Characteristic trophic skin disorders
(ulcers, ulcerations, etc.). Skin pigmentation is more often combined with depigmentation sites, which makes the skin variegated.
In the differential diagnosis of Addison’s disease and the pigment form of toxic goiter against the latter, characteristic clinical signs (goiter, ocular symptoms, increased systolic and pulse pressure, etc.) and laboratory findings of the survey (increase in blood fatty acids, increased basal metabolic rate and the inclusion of I in the thyroid
When acanthosis nigricans clinical and laboratory are missing
signs of adrenal insufficiency. In the latter stages of the disease, in contrast to Addison’s disease, hyperkeratosis and papillomatous growths of the skin are present.
In the differential diagnosis of skin pigmentation, caused by chronic insufficiency of the adrenal cortex, and other types of skin pigmentation, history, as well as clinical and laboratory data of the study, are crucial.
Forecast. The prognosis of the disease depends on the nature, severity of the pathological process, the timeliness of diagnosis and the effectiveness of treatment. With properly organized treatment, patients live 15–20 years or more. Without treatment, the prognosis
regarding life is unfavorable. A less favorable prognosis for tuberculous lesions of the adrenal glands and more favorable at their simple atrophy. Addisonic crisis, coma, as well as severe hypoglycemia are the most dangerous for patients.
In the mild form of Addison’s disease, mental workers often retain their ability to work. However, patients are contraindicated with work associated with significant neuropsychic stress. In the mild form of the disease, physiotherapy
labor often become disabled in group III. The disease of moderate severity usually leads to disability of group III, py, and in severe form – group II and even group I.
Treatment. In the mild form of the disease, a diet is prescribed with a sufficient content of proteins, fats, carbohydrates, sodium salts of vitamins C and group B and poor in potassium salts. In the diet sharply limit the meat. Peas, beans, nuts, bananas, baked potatoes, cocoa and other products containing a large amount of potassium are excluded from the diet. Additionally, up to 10 g of sodium chloride, ascorbic acid (0.5—1 g).