What is the cause of the hyperpigmentation seen in people with Cushing syndrome?
a. Abnormal levels of cortisol
b. Permissive effects of aldosterone when cortisol levels are altered
c. Elevated levels of ACTH
d. Hypersensitivity of melanocytes with sun exposure
ANS: C
Bronze or brownish hyperpigmentation of the skin, mucous membranes, and hair occurs when there are very high levels of ACTH. The pigmentation changes associated with Cushing syn-drome and Addison disease are not due to increased levels of cortisol or hypersensitivity of mel-anocytes. Aldosterone affects fluid balance.
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