Endocrinology Cushing Adrenal

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.

Endocrinology

Patient 4

This is an older man with Cushing’s syndrome from a bronchial carcinoid tumor.