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OCR: lety per Pigmentation is present in more than n melanin in cent of cases; this results from increased more the skin and mucous membranes, and i ressure. readily seen in areas exposed to light or ands, Thus, the face (Fig. 9.2), the back of the h junctivae, elbows and knees, the buccal mucosa, co only nails, axillae, and skin creases are comm pigmented. 1 In a patient with suspected adrenocortic ation will insufficiency, the clinical sign of pigmer ocortical nearly always distinguish primary adren ry to either insufficiency from that which is second hypothalamic or pituitary disease.