Which clinical feature is most characteristic of Cushing's syndrome?

Which clinical feature is most characteristic of Cushing's syndrome?

• A. Bronze pigmentation
• B. Moon face with a buffalo hump
• C. Hypertension and edema without weight gain
• D. Hypoglycemia and weight loss

Answer: (B)

Excess cortisol shifts fat to certain areas and alters metabolism, producing a distinctive facial and upper-body appearance. The most characteristic sign is a round, “moon” face with a dorsocervical fat pad forming a buffalo hump. This combination happens because cortisol promotes central fat deposition and redistribution rather than a uniform weight change, which makes these features particularly telling for Cushing's syndrome. Bronze pigmentation appears with Addison's disease due to increased ACTH stimulating melanin, so it’s not typical of Cushing's. Hypertension and edema can occur with cortisol excess, but weight gain is a common feature of Cushing's, making the “no weight gain” pattern unlikely. Hypoglycemia and weight loss point away from cortisol excess and toward adrenal insufficiency.

Excess cortisol shifts fat to certain areas and alters metabolism, producing a distinctive facial and upper-body appearance. The most characteristic sign is a round, “moon” face with a dorsocervical fat pad forming a buffalo hump. This combination happens because cortisol promotes central fat deposition and redistribution rather than a uniform weight change, which makes these features particularly telling for Cushing's syndrome.

Bronze pigmentation appears with Addison's disease due to increased ACTH stimulating melanin, so it’s not typical of Cushing's. Hypertension and edema can occur with cortisol excess, but weight gain is a common feature of Cushing's, making the “no weight gain” pattern unlikely. Hypoglycemia and weight loss point away from cortisol excess and toward adrenal insufficiency.