What clinical manifestation is least likely to be seen in a patient with Cushing's syndrome?

In patients with Cushing's syndrome, several key clinical manifestations arise due to excessive levels of cortisol. One of the most characteristic features includes the redistribution of body fat, leading to a rounded face often referred to as a "moon face," which explains the gaining weight in that area. Additionally, thin extremities occur as muscle wasting happens from the catabolic effects of high cortisol levels, contributing to a body composition where extremities appear thin while the trunk of the body and face becomes more rounded.

Striae, or stretch marks, appear on the abdomen and breasts due to rapid skin stretching associated with weight gain and cortisol effects on skin integrity. These purple or red striae are another hallmark sign of Cushing's syndrome.

Increased thirst, however, is less commonly associated with Cushing's syndrome. Although some patients may experience polydipsia due to hyperglycemia or diabetes insipidus in cases of adrenal exacerbations, it is not a defining characteristic of the syndrome itself. Therefore, when considering the classic manifestations of Cushing's syndrome and the effects of cortisol on the body’s physique and metabolism, increased thirst is the clinical manifestation least likely to be seen in a typical case. This distinction is important for recognizing the condition and distinguishing it from other