Cutaneous Manifestations
Also, striking physical characteristics are thin skin [4], through which it is possible to visualize the vascular network, in addition to violet streaks. Such manifestations occur due to the decrease in dermal collagen, because cortisol promotes protein catabolism, especially in tissues rich in collagen. The preference for such tissues is due to the composition of collagen, which when catabolized becomes the largest source of the amino acid alanine in the body. Alanine will be used as a raw material in hepatic glycogenesis, which will be increased due to hypercortisolism. Collagen deficiency also affects vascular walls, leading to the formation of bruises and cutaneous hematomas from minor traumas. Finally, as a consequence of greater collagen catabolism, there will also be a longer time for wound healing [5].