|
| Fig. 36.5 Cushing’s syndrome (excess glucocorticoids), showing truncal obesity and abdominal striae. (Courtesy of James E. Fitzpatrick, MD.) |
The skin is generally thin and atrophic. Wound repair is inhibited, and striae developed in sites such as the abdomen, upper chest, and buttocks, where the skin is normally stretched. These striae are often large and purple in color, in contrast to idiopathic or pregnancyinduced striae (Fig. 36-5). The skin has a ruddy appearance, and telangiectasias may be prominent. The skin bruises and tears easily. Other skin changes include hypertrichosis, dryness, fragility of the skin, and facial acne. These changes may also be seen in skin that has been treated with high-strength topical steroids for long periods of time. Broadened facial features (moon facies), increased subcutaneous fat on the upper back and neck (buffalo hump), and truncal obesity are also characteristic.
