Which skin change would the nurse expect to find in a patient with hypercortisolism?

Which skin change would the nurse expect to find in a patient with hypercortisolism?

• A. Reddish-Purple Striae
• B. Hyperpigmentation
• C. Petechiae
• D. Acne

Answer: (A)

Hypercortisolism weakens skin by reducing collagen production and thinning the dermis, so the skin becomes fragile and less able to stretch. This leads to wide, reddish-purple striae that commonly appear on the abdomen, breasts, thighs, and other areas where skin is under tension. The color comes from the underlying blood vessels being more visible as the skin thins, and these striae often take on a purplish hue before fading over time. Hyperpigmentation is more typical of Addison disease due to high ACTH stimulating melanocytes. Petechiae can occur with capillary fragility but isn’t the defining sign of hypercortisolism. Acne can be present in Cushing’s but is less specific than the characteristic striae. Thus, reddish-purple stretch marks are the most expected skin change in hypercortisolism.

Hypercortisolism weakens skin by reducing collagen production and thinning the dermis, so the skin becomes fragile and less able to stretch. This leads to wide, reddish-purple striae that commonly appear on the abdomen, breasts, thighs, and other areas where skin is under tension. The color comes from the underlying blood vessels being more visible as the skin thins, and these striae often take on a purplish hue before fading over time.

Hyperpigmentation is more typical of Addison disease due to high ACTH stimulating melanocytes. Petechiae can occur with capillary fragility but isn’t the defining sign of hypercortisolism. Acne can be present in Cushing’s but is less specific than the characteristic striae. Thus, reddish-purple stretch marks are the most expected skin change in hypercortisolism.