What physical sign is commonly associated with hypercortisolism?

Hypercortisolism, often referred to as Cushing's syndrome, can lead to a variety of physical signs due to excessive levels of cortisol in the body. One notable manifestation is the presence of striae, which are also commonly known as stretch marks. These striae often have a distinct appearance; they can be wide, purplish or reddish in color, and are typically seen in areas such as the abdomen, thighs, and breasts.

The development of striae in hypercortisolism is primarily attributed to the effect of elevated cortisol levels on skin elasticity and collagen synthesis. As cortisol increases, it disrupts the normal production and maintenance of collagen, leading to increased fragility of the skin and the formation of striae. These marks can be considered a direct indicator of the underlying hormonal imbalance associated with this condition.

Other signs of hypercortisolism include facial plethora, which manifests as a rounded or puffy face, and an increased risk for diabetes, hypertension, and obesity. While acanthosis nigricans and exophthalmos are related to other conditions—such as insulin resistance and hyperthyroidism, respectively—striae are specifically linked to the excessive levels of cortisol found in Cushing's syndrome, making them a