Thin Skin
Dermal atrophy (cigarette paper thin) due to steroid inhibition of collagen synthesis. Thin skin is established when a skin fold over the proximal phalanx of the middle finger of the nondominant hand is <2 mm thick. This finding carries a high positive likelihood ratio (115) for Cushing’s syndrome.
Patient 1:
This is a previously healthy young man who presented with rapid weight gain, and was ultimately diagnosed with Cushing’s syndrome from an ectopic source of ACTH. Despite imaging, the source was never located and the patient ultimately underwent bilateral adrenalectomy. In the first photo, the examiner’s hand is pictured on top for comparison.
This patient also has moon facies, a buffalo hump, easy bruising, and abdominal striae.
Patient 2:
This patient has
Patient 3:
This patient has
Patient 4:
This is an older man with Cushing’s syndrome from a bronchial carcinoid tumor.
