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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 ows and Thus, the face, the back of the hands, elb nails, knees, the buccal mucosa, conjunctivae monly axillae, and skin creases (Fig. 9.4) are cor pigmented. In a patient with suspected adrenocortic ation will insufficiency, the clinical sign of pigmer ocortical nearly always distinguish primary adrer ry to either insufficiency from that which is second hypothalamic or pituitary disease.