Which of the following symptoms is characteristic of Cushing syndrome?

Hypercortisolism results from prolonged exposure to excessive levels of circulating glucocorticoids, often due to pituitary adenomas or exogenous steroid use. This hormonal imbalance causes profound metabolic derangements and systemic physical alterations. Common clinical features include centripetal obesity, hypertension, and dermal changes. Management focus includes identifying the etiological trigger and normalizing cortisol. Rationale: A. Upper body slenderness is the opposite of the clinical presentation seen in hypercortisolism. Patients typically exhibit centripetal obesity, which involves weight gain in the trunk and abdomen. The extremities often appear thin due to significant muscle wasting and the mobilization of peripheral structural proteins. B. Facial puffiness with a moon-shaped appearance, known as moon facies, is a hallmark sign of Cushing syndrome. This occurs due to the redistribution of adipose tissue under the influence of chronic glucocorticoid excess. It is often accompanied by a "buffalo hump" in the dorsocervical region of the neck. C. Thick skin is incorrect, as glucocorticoid excess leads to the inhibition of collagen synthesis and fibroblasts. This results in fragile skin that is abnormally thin and prone to easy bruising. Characteristic wide, purple striae often develop on the abdomen and thighs due to this dermal thinning. D. Hypoglycemia is not characteristic; rather, hypercortisolism frequently leads to hyperglycemia and secondary diabetes mellitus. Cortisol stimulates gluconeogenesis and antagonizes the effects of insulin in peripheral tissues. This creates a state of insulin resistance, resulting in elevated blood glucose levels rather than a deficit.