Skin Manifestation of Cushing Syndrome

Introduction:

Cushing syndrome is a condition that can be characterized by skin and systemic symptoms. The skin is an important organ of the human body that responds to hormone fluctuations. Cushing syndrome shows several skin changes due to hormone alterations. The condition occurs due to the production or administration of excess cortisol in the human body. This may affect the skin's integrity and appearance. The common cutaneous manifestations of Cushing syndrome include the development of red or purple stretch marks on the skin due to an interruption in collagen production and synthesis. The common locations on the skin include arms, abdomen, thighs, and buttocks. The other symptoms include skin thinning, sin fragility, skin bruising, and rapid weight gain. There is an increase in the blood flow and small blood vessels dilatation leading to skin flushing appearance. Understanding the condition may help in early diagnosis and management of the condition. The article discusses the skin manifestation of Cushing syndrome, its diagnosis, and its treatment.

What Is Cushing Syndrome?

Cushing syndrome is a medical disorder in which there is an excess increase in the levels of cortisol in the human body. Cortisol is the steroid hormone that is formed by the adrenal glands. There are two types of Cushing syndrome, such as exogenous and endogenous Cushing syndrome.

• The exogenous Cushing syndrome occurs when there is an excessive intake of corticosteroid medications, including Dexamethasone and Prednisone. These medications are taken for various medical conditions. The endogenous Cushing syndrome occurs when there is an excessive production of cortisol within the human body.

• The main reason behind the occurrence of endogenous Cushing syndrome is a tumor in the pituitary gland. The tumor produces adrenocorticotropic hormone, which in turn activates the adrenal glands and forms more cortisol.

What Are the Causes of Cushing Syndrome?

The causes of Cushing syndrome are described below:

• Pituitary Adenoma: The pituitary tumor or pituitary adenoma leads to the building of adrenocorticotropic hormone. This leads to the excessive secretion of cortisol and causes the development of the condition.

• Adrenal Tumors: Adrenal gland tumors are either cancerous or non-cancerous. It leads to the production of cortisol and Cushing syndrome.

• Familial Cushing Syndrome: The other cause of the development of Cushing syndrome is the genetic predisposition to develop tumors.

• Excessive Intake of Medications: Excessive intake of corticosteroids can result in Cushing syndrome. These medications are prescribed in conditions, such as autoimmune diseases, inflammatory disorders, and asthma.

What Are the Skin Manifestations of Cushing Syndrome?

The skin or cutaneous manifestations of Cushing syndrome are as follows:

• Purple or Red Striae: The common cutaneous manifestation of Cushing syndrome is the formation of red or purple scratch marks or striae on the skin. The other name of purple or red striae is angiotelectasia. The cause of the formation of purple or red striae is the excessive production of cortisol levels in the human body and the dilatation of blood vessels. The common location of stretch marks are arms, abdomen, buttocks, thighs, and abdomen. It shows rapid weight gain.

• Skin Thinning: The other name of skin thinning is skin atrophy. It makes the skin more fragile. The cause of the condition is the effects of cortisol on collagen production leading to the reduction of skin thickness causing skin thinning. This may increase the risk of skin bruising and skin tearing.

• Skin Infections: The syndrome tends to increase skin infections and acne formation. It is due to the effects of elevated cortisol. It may compromise the ability of the skin to fight off against infections. The compromised immune system may worsen the existing acne.

• Bruising: There is a tendency for skin bruising. The other name for skin bruising is ecchymosis. The bruising is due to the weakened blood vessels and skin thinning. The location of bruising is the area of minor trauma.

• Hyperpigmentation: The person may experience skin darkening in the affected area. It may be due to an increase in melanin production and adrenocorticotrophic hormone. It occurs in skin areas exposed to sunlight.

• Delayed Wound Healing: There may be hindrances in skin wound healing. An increase in cortisol levels may hinder the different phases of wound healing.

• Moon Face: It is a round face appearance. It is due to the fat accumulation in the facial area, such as the cheeks. There may be swelling and a reddish appearance on the skin. It is also called facial plethora.

• Dilated Blood Vessels: The blood vessels are dilated and visible near the skin surface. The other name of dilated blood vessels is telangiectasia.

• Acanthosis Nigricans: The formation of dark and velvety patches on the body folds, such as the neck, groin, and armpits.

How Is Cushing Syndrome Diagnosed?

Diagnosing skin manifestations of Cushing syndrome involves clinical evaluation, patient medical history, and laboratory tests. The diagnosis of Cushing syndrome is described below:

• Clinical Evaluation: The healthcare provider may clinically examine the patient skin and may look for skin striae, skin thinning, acne, and skin infections.

• Patient History: The healthcare provider may ask the patient about any change in the skin appearance, skin bruising, and weight gain patterns.

• Blood and Urine Tests: The doctor may suggest the patients for blood and urine tests to measure cortisol levels. An increase in cortisol levels may indicate Cushing syndrome. The elevation of adrenocorticotropic hormone levels may indicate the presence of the condition.

• Imaging Tests: The doctor may advise magnetic resonance imaging (MRI) and computed tomography (CT) scans of the pituitary gland and adrenal glands. This may help in the identification of tumors that may cause an elevation of cortisol levels.

• Skin Biopsy: It is performed to know whether the adrenal tumor is malignant or benign.

How Is Cushing Syndrome Treated?

The treatment strategies for skin manifestations of Cushing syndrome are as follows:

• Surgical Management: If the cause of the condition is a pituitary or adrenal tumor. The doctor may advise the patient for surgical removal of the tumor. In addition, radiation therapy is performed to manage the condition.

• Medical Management: The doctor may advise the patient to withdraw corticosteroids. To manage excess cortisol, Cabergoline or Pasireotide is prescribed.

• Symptomatic Management: The dermatologists may prescribe topical treatments, such as moisturizers and emollients to manage skin dryness and skin thinning. Proper wound care is required to manage skin infections.

• Nutritional Interventions: A well-balanced diet and regular physical activity may help in managing weight.

Conclusion:

In conclusion, Cushing syndrome is a condition in which there is an excessive increase in the levels of cortisol leading to the formation of red to purple stretch marks on the arms, buttocks, abdomen, thighs, and buttocks. The other symptoms include skin thinning and skin infections. The condition can be managed by surgical and medical management. Regular monitoring of hormone levels may help in managing the condition and may enhance the overall health of the patient.