Bronze skin coloration is most commonly associated with which disorder?

• A. Addison's disease
• B. Cushing syndrome
• C. Hyperthyroidism
• D. Diabetes mellitus type 2

Answer: (A)

Bronze skin coloration most often points to primary adrenal insufficiency because when the adrenal cortex fails, cortisol production drops and the pituitary increases ACTH. ACTH shares a common precursor with melanocyte-stimulating factors, so higher ACTH levels stimulate melanocytes throughout the skin, producing diffuse hyperpigmentation that can look bronze, especially in sun-exposed areas and mucous membranes.

Other conditions don’t produce this generalized bronze pigmentation. Cushing syndrome involves excess cortisol with signs like weight gain, striae, and proximal weakness rather than skin darkening. Hyperthyroidism tends to cause warm, moist skin with tachycardia rather than a bronze hue. Diabetes type 2 may show acanthosis nigricans—velvety, dark patches in folds—not bronze skin overall.