A 38-year-old female has been on corticosteroids for several months to manage severe asthma exacerbations. The patient reports weight gain, feeling anxious, experiencing insomnia, and noticing increased facial hair growth. Which of the following is the most likely explanation for these symptoms?

A. Cushing's syndrome: Prolonged use of corticosteroids can lead to iatrogenic Cushing's syndrome. Common features include weight gain (especially central), mood changes such as anxiety or irritability, insomnia, and physical changes like hirsutism (increased facial hair), moon face, and truncal obesity due to chronic hypercortisolism. B. Adrenal insufficiency: This condition typically results from abrupt withdrawal of corticosteroids, leading to fatigue, hypotension, and electrolyte imbalances. It does not cause the excess cortisol-related symptoms described in this patient’s presentation. C. Diabetes mellitus: While corticosteroids can raise blood glucose levels and increase the risk for diabetes, the described symptoms—particularly the weight distribution and hirsutism—are more indicative of Cushing’s syndrome than diabetes. D. Dystonia: Dystonia involves involuntary muscle contractions causing repetitive movements or abnormal postures. It is not associated with the metabolic and hormonal effects caused by long-term corticosteroid use.