Endocrine Abstracts

Patients with Addison’s disease classically show pigmentation of the skin before treatment which lessens on hydrocortisone therapy. There is a theoretical association between red hair and fair skin in patients who have fewer melanocytes who may not pigment so markedly or frequently as patients with brown hair when they present with Addison’s. In the Addison’s Disease Self Help Group we asked in a questionnaire, from which there were 1146 replies, what happened to pigmentation at presentation in patients who had red hair and fair skin when compared to a group of patients with brown or olive skin. In the red headed group, of which there were 83, 57% reported pigmentation as opposed to 42% who did not. In the non-redheaded group (1063) there were 13.8% who reported no pigmentation as opposed to 86% who did. For the experimental group, the frequency of pigmentation was 0.58 (95% confidence in interval 0.47-0.68). For the control group patients without red hair n = 1063, the frequency of pigmentation was 0.86 (95% confidence interval 0.84-0.88). These figures are different according to the two chi squared tests at 1 and 5%. This is the first time this observation has been made as far as we can ascertain. Further work needs to be done in a second cohort of patients to verify this and to ascertain whether red hair and a fair skin by being associated with lower rates of skin pigmentation delays diagnosis of Addison’s disease.