I am writing to convey a small reminder to the many dermatologists whom this publication reaches. It is not meant as a criticism, but is submitted with the hope that a few people may be spared some of the pain and physical deterioration my mother endured because of a much-delayed diagnosis of Cushing disease.
The earliest and ultimately most exasperating symptom that my mother experienced was tissue paper–thin skin that bruised extremely easily. This was most marked on the dorsi of her forearms and hands, and the lesions took months to heal. Something as trifling as the brush of her infant granddaughter's fingernail could literally tear her skin as if it were wet tissue paper.
Molchan S. The Importance of Early Cushing Disease Diagnosis. Arch Dermatol. 1999;135(4):474. doi:10-1001/pubs.Arch Dermatol.-ISSN-0003-987x-135-4-dlt0499