Appearance Changes:

The grotesque physical changes Cushing's patients experience are devastating not only physicially, but mentally as well. Below is a list of these changes.

  • massive weight gain, mostly in the trunk and abdomen (an abnormal fat distribution pattern)

  • thinning of the extremities due to muscle wasting leading to severe weakness in the upper arms and legs

  • purplish-red striae ("stretch marks") on abdomen, chest/breasts and under arms

  • "buffalo hump" on the back just below the neck

  • "moon face" (a pronounced rounding of the face, double chin, puffiness)

  • acne and redness of the skin, especially on the face, formation of sebaceous cysts and seborrheic keratoses ("age spots")

  • abnormal facial and body hair growth in women

  • loss or thinning of scalp hair

  • bronzed areas on the skin - most commonly on the lower abdomen

  • gray-brown velvety patches on skin on back of neck, underarms, inner thighs (acanthosis nigricans)

  • body odor changes

  • chronic skin infections

    These pronounced physical changes often lead to patients being rejected and/or ridiculed for their appearance. They may miss job opportunities, lose jobs, lose spouses, thus losing self-esteem in the process. Even physicians frequently look upon a patient with these overt appearance changes, and attribute the weight gain to a lack of self-control over eating habits. Too little attention has been paid to the devastating emotional impact of these physical changes. These patients need emotional support and perhaps pharmacological assistance to avoid worsening the depression already present. Education of families, significant others and friends in the clinical changes of Cushing's may help in their acceptance.

    Pictures of Cushing's Patients

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