Skin manifestations of Cushing’s syndrome
- 465 Downloads
Among the most common diagnostic manifestations of Cushing’s syndrome (CS) are those involving the skin; they include violaceous striae, facial acne, hirsutism, acanthosis nigricans (AN), fungal infections, hyperpigmentation (Hp) and easy bruisability. Fortunately, most resolve within a year or two after cure of CS, although light-colored striae can persist for years depending on the age of the patients. AN, Hp, and bruisability usually resolve within months after cure in almost all ages. Facial plethora (along with acne and other facial skin changes) is a typical sign of CS that is due to increased perfusion. It resolves immediately after curative therapy of CS. Typically, the severity of the manifestations does not correlate with the biochemical indices of the disease, pointing to age, gender, genetic and skin-type differences that determine the cutaneous manifestations of CS.
KeywordsCushing’s syndrome Glucocorticoids Skin Acne Plethora Hyperpigmentation Bruise Striae Hirsutism Acanthosis
This review was supported by the research project Z01-HD008920 (Principal Investigator: Dr. Constantine A Stratakis) of the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, USA.
Compliance with ethical standards
Conflict of interest
The author declares that he has no conflict of interest.
- 15.Lodish MB, Gourgari E, Sinaii N, Hill S, Libuit L, Mastroyannis S, Keil M, Batista DL, Stratakis CA. Skeletal maturation in children with Cushing syndrome is not consistently delayed: the role of corticotropin, obesity, and steroid hormones, and the effect of surgical cure. J Pediatr. 2014;164(4):801–6.CrossRefPubMedPubMedCentralGoogle Scholar
- 17.Briassoulis G, Damjanovic S, Xekouki P, Lefebvre H, Stratakis CA. The glucocorticoid receptor and its expression in the anterior pituitary and the adrenal cortex: a source of variation in hypothalamic-pituitary-adrenal axis function; implications for pituitary and adrenal tumors. Endocr Pract. 2011;17(6):941–8.CrossRefPubMedPubMedCentralGoogle Scholar
- 25.Meisler N, Shull S, Xie R, Long GL, Asher M, Connoly JP, Cutroneo KR. Glucocorticoids coordinately regulate type I collagen pro-alpha 1 promoter activity thorugh both the glucocorticoid and TGF-b response elements: a novel mechanism of glucococrtocid regulation of eukaryotic genes. J Cell Biochem. 1995;59:376–88.CrossRefPubMedGoogle Scholar
- 31.Afshari A, Ardeshirpour Y, Lodish MB, Gourgari E, Sinaii N, Keil M, Belyavskaya E, Lyssikatos C, Chowdhry FA, Chernomordik V, Anderson AA, Mazzuchi TA, Gandjbakhche A, Stratakis CA. Facial plethora: modern technology for quantifying an ancient clinical sign and its use in Cushing syndrome. J Clin Endocrinol Metab. 2015;100(10):3928–33.Google Scholar
- 32.Hannah-Shmouni F, Stratakis CA, Koch CA. Flushing in (neuro)endocrinology. Rev Endocr Metab Disord. 2016. doi: 10.1007/s11154-016-9394-8.