| • | generalized hyperpigmentation with photo-accentuation |
| • | clinical: fatigue, anorexia, weight loss |
|
| • | ACTH or MSH producing tumors (e.g. oat cell CA of lung) |
| • | Vitamin B12 deficiency (malabsorption syndromes) |
| • | generalized hyperpigmentation secondary to melanoma is frequently associated with melanouria |
| • | urine normal when voided; then gradually darkened when exposed to air for several hours |
| • | intermediary metabolites of tyrosine are oxidized spontaneously to melanin |
|
| • | progressive systemic scleroderma |
| • | hemochromatosis (bronze diabetes) |
|