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This means tongue darkening in Addison's disease is typically diffuse rather than focal, and it is almost always accompanied by other signs: darkening of skin creases, knuckles, scars, and other mucosal surfaces, along with systemic symptoms like fatigue, weight loss, low blood pressure, and salt cravings

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Still, side-by-side photos from January 2020 and November 2025 have critics pointing to slimmer facial features and a sharper jawline

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