{"id":1111,"date":"2020-05-17T14:16:48","date_gmt":"2020-05-17T21:16:48","guid":{"rendered":"https:\/\/up.physicaldiagnosispdx.com\/up\/?page_id=1111"},"modified":"2021-02-28T11:42:10","modified_gmt":"2021-02-28T19:42:10","slug":"thin-skin","status":"publish","type":"page","link":"https:\/\/up.physicaldiagnosispdx.com\/up\/endocrinology-multimedia\/thin-skin\/","title":{"rendered":"Thin Skin"},"content":{"rendered":"<div class=\"wpb-content-wrapper\">[vc_row css=&#8221;.vc_custom_1591994115638{background-color: #fff9f9 !important;}&#8221;][vc_column][vc_column_text]\n<div class=\"textLayer\"><span style=\"font-size: 14pt;\">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 &lt;2 mm thick. This finding carries a high positive likelihood ratio (115) for Cushing\u2019s syndrome.<\/span><\/div>\n<figure id=\"attachment_1658\" aria-describedby=\"caption-attachment-1658\" style=\"width: 150px\" class=\"wp-caption alignleft\"><a href=\"https:\/\/up.physicaldiagnosispdx.com\/up\/endocrinology\/endocrinology-2\/#Thin_skin\"><img decoding=\"async\" loading=\"lazy\" class=\"wp-image-1658 size-thumbnail\" src=\"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/iconfinder_3_1250308-150x150.png\" alt=\"\" width=\"150\" height=\"150\" srcset=\"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/iconfinder_3_1250308-150x150.png 150w, https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/iconfinder_3_1250308-300x300.png 300w, https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/iconfinder_3_1250308.png 512w\" sizes=\"auto, (max-width: 150px) 100vw, 150px\" \/><\/a><figcaption id=\"caption-attachment-1658\" class=\"wp-caption-text\">&nbsp;<\/figcaption><\/figure>[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text]\n<h1 id=\"patient1\">Patient 1:<\/h1>\n<p><span style=\"font-size: 14pt;\">This is a previously healthy young man who presented with rapid weight gain, and was ultimately diagnosed with Cushing\u2019s syndrome from an ectopic source of ACTH. Despite imaging, the source was never located and the patient ultimately underwent bilateral adrenalectomy. In the first photo, the examiner&#8217;s hand is pictured on top for comparison.<\/span><\/p>\n<p><span style=\"font-size: 14pt;\">This patient also has <a href=\"https:\/\/up.physicaldiagnosispdx.com\/up\/endocrinology\/endocrinology-multimedia\/moon-facies\/#patient1\" target=\"_blank\" rel=\"noopener\">moon facies<\/a>, a<a href=\"https:\/\/up.physicaldiagnosispdx.com\/up\/endocrinology\/endocrinology-multimedia\/buffalo-hump\/\"> buffalo hump, <\/a><a href=\"https:\/\/up.physicaldiagnosispdx.com\/up\/endocrinology\/endocrinology-multimedia\/bruising\/#patient1\" target=\"_blank\" rel=\"noopener\">easy bruising<\/a>, and <a href=\"https:\/\/up.physicaldiagnosispdx.com\/up\/endocrinology\/endocrinology-multimedia\/bruising\/#patient1\" target=\"_blank\" rel=\"noopener\">abdominal striae<\/a>.<\/span>[\/vc_column_text][\/vc_column][\/vc_row][vc_row css=&#8221;.vc_custom_1591994139492{background-color: #dcd9dd !important;}&#8221;][vc_column width=&#8221;1\/4&#8243;][\/vc_column][vc_column width=&#8221;3\/4&#8243;][vc_column_text]<div id='gallery-1' class='gallery galleryid-1111 gallery-columns-3 gallery-size-medium'><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon portrait'>\n\t\t\t\t<a href='https:\/\/up.physicaldiagnosispdx.com\/up\/endocrinology-multimedia\/thin-skin\/endocrinology_cushings-syndrome_thin-skin_img_6725\/'><img loading=\"lazy\" decoding=\"async\" width=\"225\" height=\"300\" src=\"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/Endocrinology_Cushings-Syndrome_Thin-Skin_IMG_6725-scaled-225x300.jpg\" class=\"attachment-medium size-medium\" alt=\"\" srcset=\"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/Endocrinology_Cushings-Syndrome_Thin-Skin_IMG_6725-scaled-225x300.jpg 225w, https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/Endocrinology_Cushings-Syndrome_Thin-Skin_IMG_6725-scaled-768x1024.jpg 768w, https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/Endocrinology_Cushings-Syndrome_Thin-Skin_IMG_6725-scaled-1152x1536.jpg 1152w, https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/Endocrinology_Cushings-Syndrome_Thin-Skin_IMG_6725-scaled-1536x2048.jpg 1536w, https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/Endocrinology_Cushings-Syndrome_Thin-Skin_IMG_6725-scaled.jpg 1920w\" sizes=\"auto, (max-width: 225px) 100vw, 225px\" \/><\/a>\n\t\t\t<\/div><\/figure>\n\t\t<\/div>\n[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text]\n<h1>Patient 2:<\/h1>\n<p><span style=\"font-size: 14pt;\">This patient has<\/span>[\/vc_column_text][\/vc_column][\/vc_row][vc_row css=&#8221;.vc_custom_1591994166178{background-color: #dcd9dd !important;}&#8221;][vc_column width=&#8221;1\/4&#8243;][\/vc_column][vc_column width=&#8221;3\/4&#8243;][vc_column_text]<img decoding=\"async\" loading=\"lazy\" class=\"alignleft wp-image-3652 size-large\" src=\"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/Endocrinology_Cushings-Syndrome_Thin-Skin_Cushing-scar-3-1024x768.jpg\" alt=\"\" width=\"640\" height=\"480\" srcset=\"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/Endocrinology_Cushings-Syndrome_Thin-Skin_Cushing-scar-3-1024x768.jpg 1024w, https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/Endocrinology_Cushings-Syndrome_Thin-Skin_Cushing-scar-3-300x225.jpg 300w, https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/Endocrinology_Cushings-Syndrome_Thin-Skin_Cushing-scar-3-768x576.jpg 768w, https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/Endocrinology_Cushings-Syndrome_Thin-Skin_Cushing-scar-3-1536x1152.jpg 1536w, https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/Endocrinology_Cushings-Syndrome_Thin-Skin_Cushing-scar-3.jpg 1600w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/>[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text]\n<h1>Patient 3:<\/h1>\n<p>&nbsp;<\/p>\n<p><span style=\"font-size: 14pt;\">This patient has<\/span>[\/vc_column_text][vc_column_text][\/vc_column_text][\/vc_column][\/vc_row][vc_row css=&#8221;.vc_custom_1591994183671{background-color: #dcd9dd !important;}&#8221;][vc_column width=&#8221;1\/4&#8243;][\/vc_column][vc_column width=&#8221;3\/4&#8243;][vc_column_text]<div id='gallery-2' class='gallery galleryid-1111 gallery-columns-3 gallery-size-medium'><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/up.physicaldiagnosispdx.com\/up\/endocrinology_cushings-syndrome_thin-skin_cushing-hand-1\/'><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"225\" src=\"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/Endocrinology_Cushings-Syndrome_Thin-Skin_Cushing-hand-1-300x225.jpg\" class=\"attachment-medium size-medium\" alt=\"\" srcset=\"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/Endocrinology_Cushings-Syndrome_Thin-Skin_Cushing-hand-1-300x225.jpg 300w, https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/Endocrinology_Cushings-Syndrome_Thin-Skin_Cushing-hand-1.jpg 556w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a>\n\t\t\t<\/div><\/figure><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/up.physicaldiagnosispdx.com\/up\/endocrinology-multimedia\/thin-skin\/endocrinology_cushings-syndrome_thin-skin_cushing-hand\/'><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"225\" src=\"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/Endocrinology_Cushings-Syndrome_Thin-Skin_Cushing-hand-wpp1591116531920-300x225.jpg\" class=\"attachment-medium size-medium\" alt=\"\" srcset=\"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/Endocrinology_Cushings-Syndrome_Thin-Skin_Cushing-hand-wpp1591116531920-300x225.jpg 300w, https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/Endocrinology_Cushings-Syndrome_Thin-Skin_Cushing-hand-wpp1591116531920-768x576.jpg 768w, https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/Endocrinology_Cushings-Syndrome_Thin-Skin_Cushing-hand-wpp1591116531920.jpg 960w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a>\n\t\t\t<\/div><\/figure>\n\t\t<\/div>\n[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text]\n<h1>Patient 4:<\/h1>\n<p><span style=\"font-size: 14pt;\">This is an older man with Cushing&#8217;s syndrome from a bronchial carcinoid tumor.<\/span>[\/vc_column_text][\/vc_column][\/vc_row][vc_row css=&#8221;.vc_custom_1592155788700{background-color: #dcd9dd !important;}&#8221;][vc_column width=&#8221;1\/4&#8243;][\/vc_column][vc_column width=&#8221;3\/4&#8243;][vc_column_text]<div id='gallery-3' class='gallery galleryid-1111 gallery-columns-3 gallery-size-medium'><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon portrait'>\n\t\t\t\t<a href='https:\/\/up.physicaldiagnosispdx.com\/up\/img_3011\/'><img loading=\"lazy\" decoding=\"async\" width=\"225\" height=\"300\" src=\"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/IMG_3011-225x300.jpg\" class=\"attachment-medium size-medium\" alt=\"\" srcset=\"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/IMG_3011-225x300.jpg 225w, https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/IMG_3011-768x1024.jpg 768w, https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/IMG_3011-1152x1536.jpg 1152w, https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/IMG_3011-1536x2048.jpg 1536w\" sizes=\"auto, (max-width: 225px) 100vw, 225px\" \/><\/a>\n\t\t\t<\/div><\/figure><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon portrait'>\n\t\t\t\t<a href='https:\/\/up.physicaldiagnosispdx.com\/up\/img_3008\/'><img loading=\"lazy\" decoding=\"async\" width=\"225\" height=\"300\" src=\"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/IMG_3008-225x300.jpg\" class=\"attachment-medium size-medium\" alt=\"\" srcset=\"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/IMG_3008-225x300.jpg 225w, https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/IMG_3008-768x1024.jpg 768w, https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/IMG_3008-1152x1536.jpg 1152w, https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/IMG_3008-1536x2048.jpg 1536w\" sizes=\"auto, (max-width: 225px) 100vw, 225px\" \/><\/a>\n\t\t\t<\/div><\/figure>\n\t\t<\/div>\n[\/vc_column_text][\/vc_column][\/vc_row]\n<\/div>","protected":false},"excerpt":{"rendered":"<p>[vc_row css=&#8221;.vc_custom_1591994115638{background-color: #fff9f9 !important;}&#8221;][vc_column][vc_column_text] 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 &lt;2 mm thick. This finding carries a high positive likelihood ratio (115) for<\/p>\n","protected":false},"author":9,"featured_media":0,"parent":1047,"menu_order":0,"comment_status":"open","ping_status":"closed","template":"page-templates\/page_PDXPDX-full-width.php","meta":{"nf_dc_page":"","_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"class_list":["post-1111","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-json\/wp\/v2\/pages\/1111","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-json\/wp\/v2\/users\/9"}],"replies":[{"embeddable":true,"href":"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-json\/wp\/v2\/comments?post=1111"}],"version-history":[{"count":2,"href":"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-json\/wp\/v2\/pages\/1111\/revisions"}],"predecessor-version":[{"id":10354,"href":"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-json\/wp\/v2\/pages\/1111\/revisions\/10354"}],"up":[{"embeddable":true,"href":"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-json\/wp\/v2\/pages\/1047"}],"wp:attachment":[{"href":"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-json\/wp\/v2\/media?parent=1111"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}