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Increased pigmentation of the skin and mucous membranes, especially on sun-exposed areas and those subject to friction, such as knuckles, skin creases, elbows, scars, breast areola (caused by stimulation of dermal melanocortin receptors due to high ACTH and other pro-opiomelanocortin peptides). Low blood pressure. Orthostatic hypotension. Failure to thrive in children.
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