Pigmentation skin disorders: Pathology review

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Preguntas

Preguntas del estilo USMLE Step 1

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A 27-year-old woman comes to her outpatient provider for skin lesions most prominent at the armpits and neck. In addition, the patient has a history of irregular menstrual cycles that occur every 2-3 months. She has not had any recent weight loss, fatigue, nausea, or weakness. Family history is notable for Addison disease in her mother. Temperature is 37.6°C (99.7°F), blood pressure is 130/74 mmHg, and pulse is 72/min. BMI is 31 kg/m2. Examination of the patient’s bilateral axillae reveals the following finding:


Reproduced from: Wikimedia Commons

 Similar lesions are found in the neck folds. They are neither painful nor pruritic. Examination of the face reveals hair growth on the upper lip and chin. Cardiac and pulmonary examinations are noncontributory. Which of the following is the most likely underlying cause for this patient’s condition? 

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