Sünkel S, Wichmann-Hesse A, Gärtner R, Hesse G
Ludwig-Maximilians-Universität München Klinikum Innenstadt, Medizinische Klinik, Endokrinologische Ambulanz.
Hautarzt. 2001 Oct;52(10 Pt 2):974-6. doi: 10.1007/s001050170011.
An 18-year old man presented with increasing pigmentation in multiple nevi as well as so-called "eruptive nevi" over a 24 month period. The first excisional biopsy was from a plantar nevus which showed melanocytic hyperplasia. Following excisions of both hyperpigmented and newly appearing nevi showed only increased pigmentation. Two years after the first examination Addison-like hyperpigmentation was noticed in typical locations. Both Addison disease and Hashimoto thyroiditis were then confirmed by elevated serum levels of ACTH, TSH, and decreased levels of cortisol and L-thyroxine. This confirmed the diagnosis of Schmidt syndrome as part of polyglandular autoimmune disease (PGAS) type II. After another 18 months of treatment with hormone substitution of L-thyroxine and hydrocortisone, the hyperpigmentation resolved and the hyperpigmented nevi decreased in number.
一名18岁男性在24个月内出现多个痣的色素沉着增加以及所谓的“发疹性痣”。首次切除活检取自足底痣，显示黑素细胞增生。切除色素沉着增加的痣和新出现的痣后，仅显示色素沉着增加。首次检查两年后，在典型部位发现了Addison样色素沉着。随后，血清促肾上腺皮质激素（ACTH）、促甲状腺激素（TSH）水平升高，皮质醇和左旋甲状腺素水平降低，证实患有Addison病和桥本甲状腺炎。这确诊了施密特综合征是Ⅱ型多腺体自身免疫性疾病（PGAS）的一部分。在用左旋甲状腺素和氢化可的松进行激素替代治疗18个月后，色素沉着消退，色素沉着的痣数量减少。
