Secondary adrenal insufficiency physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Physical Examination

Appearance

• The patient may be dehydrated and lethargic.

Vital Signs

• Low blood pressure that falls further when standing (orthostatic hypotension)
• Cardiovascular collapse may be present

Skin

• There can be tanning of the skin. Tanning of the skin that may be patchy or even all over the body. Characteristic sites of tanning are skin creases (e.g. of the hands) and the inside of the cheek (buccal mucosa).
• Vitiligo may also be present.
• Absence of axillary and pubic hair in females as a result of loss of adrenal androgens.
• Pallor may be present.

Neck

• Goitre may be present