Cushing's Syndrome Reflected in the Skin

The document discusses a case of Cushing's syndrome, an endocrine disorder characterized by chronic exposure to excess corticosteroids, which is often challenging to diagnose due to nonspecific symptoms. The syndrome is usually caused by increased adrenocorticotropic hormone (ACTH) production from a pituitary adenoma, known as Cushing's disease. Dermatological manifestations such as fragile skin, easy bruising, and reddish-purple striae can be more indicative of the condition. The case presented involves a 33-year-old female patient who sought medical attention for hair loss, which is a common complaint but rarely the presenting symptom of Cushing's disease. Despite treatment with 5% Minoxidil foam, her hair loss did not improve. Further examination revealed multiple dermatological signs, including facial plethora, easy bruising, violaceous striae, hirsutism, and acne, indicative of androgen excess. Laboratory tests confirmed the diagnosis of Cushing's syndrome, with elevated levels of urine cortisol, serum dehydroepiandrosterone sulfate (DHEA-S), and ACTH. The study emphasizes the importance of early diagnosis and treatment of Cushing's syndrome due to its association with increased morbidity, particularly cardiovascular diseases. The skin can reflect the first signs of Cushing's syndrome and serve as an indicator for timely diagnosis, necessitating interdisciplinary collaboration in the diagnostic and treatment process.