Aesthetics and Emotional State in Patients with Cushing's Syndrome

Authors

DOI:

https://doi.org/10.70577/dp65ng43

Keywords:

Cushing syndrome; hypercortisolism; nursing; quality of life; self-care.

Abstract

Introduction: Cushing syndrome is a multisystem endocrine condition caused by chronic exposure to elevated cortisol levels. Its visible physical manifestations, metabolic complications, and psychosocial consequences affect functionality, body image, self-esteem, and quality of life. Objective: To analyze recent scientific evidence on the clinical manifestations, complications, psychosocial impact, and relevance of nursing care in people with Cushing syndrome. Methodology: A review of recent scientific publications was conducted and organized in an analytical matrix including authors, title, methodology, main findings, and relevance to nursing. The information was refined, synthesized, and interpreted from a clinical and disciplinary perspective. Results: The reviewed evidence shows that Cushing syndrome is associated with central obesity, moon face, facial plethora, dorsocervical fat pad, purple striae, hirsutism, acne, skin fragility, ecchymosis, proximal muscle weakness, arterial hypertension, diabetes mellitus, emotional disturbances, and impaired quality of life. Cardiometabolic, musculoskeletal, thromboembolic, and neuropsychiatric complications were also identified. Conclusion: Cushing syndrome requires comprehensive, continuous, and humanized assessment. Nursing plays a relevant role in early detection, self-care education, complication surveillance, psychosocial support, and continuity of care.

Downloads

Download data is not yet available.

References

Akirov, A. (2025). Hypercoagulability in Cushing’s syndrome: Past, present, and future. Archives of Endocrinology and Metabolism, e250062. https://doi.org/10.20945/2359-4292-2025-0095 DOI: https://doi.org/10.20945/2359-4292-2025-0095

Braun, L. T., Vogel, F., Zopp, S., Marchant Seiter, T., Rubinstein, G., Berr, C. M., Künzel, H., Beuschlein, F., & Reincke, M. (2022). Whom Should We Screen for Cushing Syndrome? The Endocrine Society Practice Guideline Recommendations 2008 Revisited. The Journal of clinical endocrinology and metabolism, 107(9), e3723–e3730. https://doi.org/10.1210/clinem/dgac379 DOI: https://doi.org/10.1210/clinem/dgac379

Bednarski, F. B. (2026). Changes in body image and pain in patients with Cushing syndrome: A predictor for depression and vice versa. Journal of the Endocrine Society, 10(3), bvaf226. https://doi.org/10.1210/jendso/bvaf226 DOI: https://doi.org/10.1210/jendso/bvaf226

Ceccato, F., Barbot, M., Mondin, A., Boscaro, M., Fleseriu, M., & Scaroni, C. (2023). Dynamic Testing for Differential Diagnosis of ACTH-Dependent Cushing Syndrome: A Systematic Review and Meta-analysis. The Journal of clinical endocrinology and metabolism, 108(5), e178–e188. https://doi.org/10.1210/clinem/dgac686 DOI: https://doi.org/10.1210/clinem/dgac686

Concepción-Zavaleta, M. J., Armas, C. D., Quiroz-Aldave, J. E., García-Villasante, E. J., Gariza-Solano, A. C., Durand-Vásquez, M. D. C., Concepción-Urteaga, L. A., & Zavaleta-Gutiérrez, F. E. (2023). Cushing disease in pediatrics: an update. Annals of pediatric endocrinology & metabolism, 28(2), 87–97. https://doi.org/10.6065/apem.2346074.037 DOI: https://doi.org/10.6065/apem.2346074.037

DeFronzo, R. A., & Auchus, R. J. (2025). Cushing Syndrome, Hypercortisolism, and Glucose Homeostasis: A Review. Diabetes, 74(12), 2168–2178. https://doi.org/10.2337/db25-0120 DOI: https://doi.org/10.2337/db25-0120

Ekbom, K. (2022). The impact of adherence and therapy regimens on quality of life in patients with congenital adrenal hyperplasia. Clinical Endocrinology, 96. https://doi.org/10.1111/cen.14676 DOI: https://doi.org/10.1111/cen.14676

Espinosa de los Monteros-Sánchez, A. L., Cuevas-Ramos, D., Espinosa-Cárdenas, E., Hinojosa-Amaya, J. M., Reza-Albarrán, A. A., Navas-Minero, C. E., Balderrama-Soto, A., Rangel, G., Vergara-López, A., Abreu-Rosario, C., Rivera-Hernández, A., Valdivia-López, J. A., Portocarrero-Ortiz, L. A., Nava-de la Vega, A., Carrillo-González, P. A., & Mercado-Atri, M. (2023). Diagnóstico y tratamiento de la enfermedad de Cushing: Actualidades y posicionamiento del Grupo de Trabajo de Neuroendocrinología de la Sociedad Mexicana de Nutrición y Endocrinología. Revista Mexicana de Endocrinología, Metabolismo & Nutrición, 10(Supl. 1), 9–32. https://doi.org/10.24875/RME.M23000025

Ferrante, E., Simeoli, C., Mantovani, G., & Pivonello, R. (2025). Who and how to screen for endogenous hypercortisolism in patients with mood disorders. Journal of endocrinological investigation, 48(Suppl 1), 75–82. https://doi.org/10.1007/s40618-024-02457-5 DOI: https://doi.org/10.1007/s40618-024-02457-5

Ferriere, A., Nunes, M. L., & Tabarin, A. (2025). Approach to the Patient With Cyclical Cushing Syndrome. The Journal of clinical endocrinology and metabolism, 110(7), e2338–e2346. https://doi.org/10.1210/clinem/dgae864 DOI: https://doi.org/10.1210/clinem/dgae864

Feller, A., Mendoza, L., Ferrari, C., Mattone, M. C., Aziz, M., Strambach, J., Pérez Espinosa, C., Flores, P., Galluzzo Mutti, L., Ramírez, P., & Costanzo, M. (2026). Cyclic Cushing syndrome and endocrine disorders in two children with Carney complex. Síndrome de Cushing cíclico y alteraciones endocrinas en dos niños con complejo de Carney. Archivos argentinos de pediatria, 124(1), e202510743. https://doi.org/10.5546/aap.2025-10743.eng DOI: https://doi.org/10.5546/aap.2025-10743

Fleseriu, M., Auchus, R. J., Bancos, I., Ben-Shlomo, A., Bertherat, J., & Biermasz, N. R.† (2021). Consensus on diagnosis and management of Cushing’s disease: A guideline update. The Lancet Diabetes & Endocrinology, 9(12), 847–875. https://doi.org/10.1016/S2213-8587(21)00235-7 DOI: https://doi.org/10.1016/S2213-8587(21)00235-7

Flowers, K. C., & Shipman, K. E. (2023). Pitfalls in the Diagnosis and Management of Hypercortisolism (Cushing Syndrome) in Humans; A Review of the Laboratory Medicine Perspective. Diagnostics (Basel, Switzerland), 13(8), 1415. https://doi.org/10.3390/diagnostics13081415 DOI: https://doi.org/10.3390/diagnostics13081415

Halstrom, A. (2024). Different patient versus provider perspectives on living with Cushing’s disease. Pituitary, 27(2). https://doi.org/10.1007/s11102-024-01381-4 DOI: https://doi.org/10.1007/s11102-024-01381-4

García L, Mora M, González-Pinto L, Fernández M, Rodríguez A. (2024). Hipercortisolismo endógeno: diferentes formas de presentación, Rev Esp Endocrinol Pediatr, 15 Suppl(1),83-87. https://doi.org/10.3266/RevEspEndocrinolPediatr.pre2024.Mar.883

Gilis-Januszewska, A., Bogusławska, A., Rzepka, E., Ziaja, W., & Hubalewska-Dydejczyk, A. (2022). Individualized medical treatment options in Cushing disease. Frontiers in endocrinology, 13, 1060884. https://doi.org/10.3389/fendo.2022.1060884 DOI: https://doi.org/10.3389/fendo.2022.1060884

Gutiérrez-Restrepo J, Tenorio-Plaza M, Román-González A. (2025). Prevención y manejo de la enfermedad tromboembólica venosa en el síndrome de Cushing. Una propuesta a partir de un caso y revisión de la literatura. Iatreia, 38(3), 470-483. https://doi.org/10.17533/udea.iatreia.320 DOI: https://doi.org/10.17533/udea.iatreia.320

Hayes, A. R. (2022). Distinguishing Cushing’s disease from the ectopic ACTH syndrome: Needles in a haystack or hiding in plain sight? Journal of Neuroendocrinology, e13137. https://doi.org/10.1111/jne.13137 DOI: https://doi.org/10.1111/jne.13137

He, X., Findling, J. W., & Auchus, R. J. (2022). Glucocorticoid Withdrawal Syndrome following treatment of endogenous Cushing Syndrome. Pituitary, 25(3), 393–403. https://doi.org/10.1007/s11102-022-01218-y DOI: https://doi.org/10.1007/s11102-022-01218-y

Hinojosa-Amaya, J. M. (2023). Diagnóstico y tratamiento de la enfermedad de Cushing: Actualidades y posicionamiento del Grupo de Trabajo de Neuroendocrinología de la Sociedad Mexicana de Nutrición y Endocrinología. Revista Mexicana de Endocrinología, Metabolismo y Nutrición, 9–32. https://doi.org/10.24875/RME.M23000025 DOI: https://doi.org/10.24875/RME.M23000025

Iara M & Beskow E. (2024). La experiencia emocional de adultos que padecen síndrome de Cushing en Argentina. Psíntesis, 1(1), 107-133. https://doi.org/10.56487/qzrh4k10

John TA, Anastasopoulou C. Hypercortisolism (Cushing Syndrome) [Updated 2025 Nov 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK551526/

Jones, S. N. (2024). “The healthcare system did fail me repeatedly”: A qualitative study on experiences of healthcare among Canadian women with Cushing’s syndrome. BMC Primary Care, 25, Article 329. https://doi.org/10.1186/s12875-024-02580-5 DOI: https://doi.org/10.1186/s12875-024-02580-5

Katabami, T., Asai, S., Matsuba, R., Sone, M., Izawa, S., Ichijo, T., Tsuiki, M., Okamura, S., Yoshimoto, T., Otsuki, M., Takeda, Y., Naruse, M., Tanabe, A., & ACPA-J Study Group (2025). Changes in clinical features of adrenal Cushing syndrome: a national registry study. Endocrine connections, 14(5), e240684. https://doi.org/10.1530/EC-24-0684 DOI: https://doi.org/10.1530/EC-24-0684

Kreitschmann-Andermahr, I. S.† (2018). Support needs of patients with Cushing’s disease and Cushing’s syndrome: Results of a survey conducted in Germany and the USA. International Journal of Endocrinology, 2018, Article 9014768. https://doi.org/10.1155/2018/9014768 DOI: https://doi.org/10.1155/2018/9014768

Leszczyńska, D., Szatko, A., Papierska, L., Zgliczyński, W., & Glinicki, P. (2023). Musculoskeletal complications of Cushing syndrome. Reumatologia, 61(4), 271–282. https://doi.org/10.5114/reum/169889 DOI: https://doi.org/10.5114/reum/169889

Lhul, R. V. D. S.† (2026). Cushing’s syndrome: A systematic review of psychiatric and cognitive symptoms in case studies. Archives of Endocrinology and Metabolism, 70(1). https://doi.org/10.20945/2359-4292-2026-0029 DOI: https://doi.org/10.20945/2359-4292-2026-0029

Lin, T. Y. (2020). Psychiatric symptoms in Cushing’s syndrome: A systematic review. Innovations in Clinical Neuroscience, 17(1). https://pmc.ncbi.nlm.nih.gov/articles/PMC7239565/

Maillen Michel, I.† (2024). La experiencia emocional de adultos que padecen síndrome de Cushing en Argentina. Psintisis, 1(1). https://doi.org/10.56487/qzrh4k10 DOI: https://doi.org/10.56487/qzrh4k10

Mamani L, Chura S, Alejo H. (2021). Síndrome de Cushing por consumo excesivo de corticoesteroides. Current Opinion Nursing & Research, 3(1). http://portal.amelica.org/ameli/jatsRepo/314/3142383005/index.html

McBride, M., Crespo, I., Webb, S., & Valassi, M. (2021). Quality of life in Cushing’s syndrome. Best Practice & Research Clinical Endocrinology & Metabolism, 35(1), Article 101505. https://doi.org/10.1016/j.beem.2021.101505 DOI: https://doi.org/10.1016/j.beem.2021.101505

Muñoz Sánchez, I. (2025). Nurses’ knowledge of rare diseases: A systematic review. Nursing Reports, 15. https://doi.org/10.3390/nursrep15090321 DOI: https://doi.org/10.3390/nursrep15090321

Nieman, L. K., Castinetti, F., Newell-Price, J., Valassi, E., Drouin, J., Takahashi, Y., & Lacroix, A. (2025). Cushing syndrome. Nature reviews. Disease primers, 11(1), 4. https://doi.org/10.1038/s41572-024-00588-w DOI: https://doi.org/10.1038/s41572-024-00588-w

Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., … Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. The BMJ, 372, n71. https://doi.org/10.1136/bmj.n71 DOI: https://doi.org/10.1136/bmj.n71

Patel, R., Sherf, S., Lai, N. B., & Yu, R. (2022). Exogenous Cushing Syndrome Caused by a "Herbal" Supplement. AACE clinical case reports, 8(6), 239–242. https://doi.org/10.1016/j.aace.2022.08.001 DOI: https://doi.org/10.1016/j.aace.2022.08.001

Rakovec, M. Z. (2023). Patient-reported outcomes and treatment satisfaction in patients with Cushing syndrome. Endocrine, 79(1). https://doi.org/10.1007/s12020-022-03214-5 DOI: https://doi.org/10.1007/s12020-022-03214-5

Reincke, M. (2023). Cushing syndrome: A review. JAMA, 330(2), 165–181. https://doi.org/10.1001/jama.2023.11305 DOI: https://doi.org/10.1001/jama.2023.11305

Rodríguez L, Marquez D, Mejía A, Pérez M & Gallego V. (2025). Hipercortisolismo endógeno: Reporte de caso adenoma hipofisario productor de ACTH enfermedad de Cushing. Revista Salud Uninorte, 41(1), 420-431. https://doi.org/10.14482/sun.41.01.999.563 DOI: https://doi.org/10.14482/sun.41.01.999.563

Rocha Guimarães , K. W., Simonassi Dantas Alves , C., Boa Sorte Alves , R., Soares de Oliveira , R., Santos Rocha , S., Fortuna Kalil de Faria, I. A., Ferreira Santana , C., de Moura Sousa , Ítalo, de Moura Sousa , I., Ávila , M. H., & Hildefonso, D. M. (2024). Síndrome de Cushing: Diagnóstico, Manejo e Avanços na Terapia Personalizada. Brazilian Journal of Implantology and Health Sciences, 6(12), 586–595. https://doi.org/10.36557/2674-8169.2024v6n12p586-595 DOI: https://doi.org/10.36557/2674-8169.2024v6n12p586-595

Rolón R, Méndez C, Cano J. (2026). Hipokalemia severa refractaria como manifestación inicial de enfermedad de Cushing. Rev. virtual Soc. Parag. Med, 13(1), e13142607. https://mail.revistaspmi.org.py/index.php/rvspmi/article/view/693/410

Theodorou, A., Tan, E. C., Bakkar, M. A., Reiner, A. S., Sazo, M., Cohen, M. A., & Geer, E. B. (2026). Prospective assessment of mood and quality of life in Cushing syndrome before and after biochemical control. The Journal of Clinical Endocrinology & Metabolism, 111(5), 1396–1411. https://doi.org/10.1210/clinem/dgaf598 DOI: https://doi.org/10.1210/clinem/dgaf598

Vaczlavik, A., Bouys, L., Violon, F., Giannone, G., Jouinot, A., Armignacco, R., Cavalcante, I. P., Berthon, A., Letouzé, E., Vaduva, P., Barat, M., Bonnet, F., Perlemoine, K., Ribes, C., Sibony, M., North, M. O., Espiard, S., Emy, P., Haissaguerre, M., Tauveron, I., … Bertherat, J. (2022). KDM1A inactivation causes hereditary food-dependent Cushing syndrome. Genetics in medicine : official journal of the American College of Medical Genetics, 24(2), 374–383. https://doi.org/10.1016/j.gim.2021.09.018 DOI: https://doi.org/10.1016/j.gim.2021.09.018

Valassi, E. (2022). Clinical presentation and etiology of Cushing’s syndrome: Data from ERCUSYN. Journal of Neuroendocrinology, e13114. https://doi.org/10.1111/jne.13114 DOI: https://doi.org/10.1111/jne.13114

Valenzuela Astudillo, V. O., Chavarrea Cadena, M. B., Tumbaco Fernández, Óscar E., López Sevilla, J. del P., Rojas Romero, A. R., Rosales Carvajal, C. B., Estévez Yépez, J. S., & Cuasapás Luna, A. D. (2024). Epidemiología, manifestaciones clínicas y diagnóstico del síndrome de Cushing: revisión de la literatura. Florence: Interdisciplinary Journal of Health and Sustainability, 2(2), e24009. https://doi.org/10.56183/florence24009 DOI: https://doi.org/10.56183/florence24009

Varlamov, E. V., Vila, G., & Fleseriu, M. (2022). Perioperative Management of a Patient With Cushing Disease. Journal of the Endocrine Society, 6(3), bvac010. https://doi.org/10.1210/jendso/bvac010 DOI: https://doi.org/10.1210/jendso/bvac010

Vela, J., Vela, M., & Valero, M. (2025). El síndrome de Cushing: Características, causas y el papel de la enfermería en el manejo integral del paciente. Revista Sanitaria de Investigación. https://revistasanitariadeinvestigacion.com/el-sindrome-de-cushing-caracteristicas-causas-y-el-papel-de-la-enfermeria-en-el-manejo-integral-del-paciente/

Webb, S. M., & Valassi, E. (2022). Quality of life impairment after a diagnosis of Cushing’s syndrome. Pituitary, 25, 768–771. https://doi.org/10.1007/s11102-022-01245-9 DOI: https://doi.org/10.1007/s11102-022-01245-9

Webb, S. M. (2018). Quality of life in Cushing’s disease: A long-term issue? Annales d’Endocrinologie, 79(3), 132–137. https://doi.org/10.1016/j.ando.2018.03.007 DOI: https://doi.org/10.1016/j.ando.2018.03.007

Zhang, M., Shi, Z., Wu, C., Yang, F., Su, T., Jing, X., Shi, J., Ren, H., Jiang, L., Jiang, Y., Zhang, C., Zhou, W., Zhou, Y., Wu, K., Zheng, S., Zhong, X., Wu, L., Gu, W., Hong, J., Wang, J., … Wang, W. (2024). Cushing Syndrome Is Associated With Gut Microbial Dysbiosis and Cortisol-Degrading Bacteria. The Journal of clinical endocrinology and metabolism, 109(6), 1474–1484. https://doi.org/10.1210/clinem/dgad766 DOI: https://doi.org/10.1210/clinem/dgad766

Downloads

Published

2026-07-08

How to Cite

Aesthetics and Emotional State in Patients with Cushing’s Syndrome. (2026). Salud Medicina E Innovación Journal, 4(3.1), 512-537. https://doi.org/10.70577/dp65ng43

Similar Articles

21-30 of 45

You may also start an advanced similarity search for this article.

Most read articles by the same author(s)