List common clinical features of Cushing syndrome.

• A. Central obesity, moon face.
• B. Hypertension and glucose intolerance.
• C. Hirsutism and skin thinning.
• D. Central obesity, moon face, buffalo hump, abdominal striae, skin thinning, hypertension, glucose intolerance, and hirsutism

Answer: (D)

Chronic cortisol excess produces a recognizable pattern of findings across fat distribution, skin, and metabolism. The hallmark is a combination of central fat gain with changes to the face and upper back, along with skin thinning and easy bruising, which together create the classic appearance seen in Cushing syndrome.

Central obesity and moon facies reflect fat redistribution from cortisol’s effects on adipose tissue and its impact on facial soft tissues. The dorsocervical fat pad, or buffalo hump, is another telltale sign of the same process. Abdominal striae that are wide and often purplish result from weakened collagen and rapid stretching of the skin. Skin thinning accompanies increased fragility and easy bruising. Beyond appearance, cortisol excess drives metabolic disturbances, notably hypertension and impaired glucose tolerance, due to insulin resistance and effects on vascular tone and electrolyte handling. In women, excess adrenal androgens can lead to increased hair growth (hirsutism).

These combined features—central obesity, moon face, buffalo hump, abdominal striae, skin thinning, hypertension, glucose intolerance, and hirsutism—together form the most complete clinical portrait of Cushing syndrome, which is why that option is the best choice. The other options list only parts of the picture and miss other key components of the syndrome.