Others may present with the features of full-blown Cushing syndrome that include the following: Truncal obesity Plethoric moon face Buffalo hump Supraclavicular fat pads Hirsutism in women Thin skin with easy bruising and wide, purplish striae Myopathy Hypertension Osteoporosis Laboratory Studies With many overlapping clinical and biochemical features, it becomes a diagnostic challenge to distinguish PCS from Cushing disease, especially in a milder form.