The most striking is the enlargement and coarsening of the facial features, hands, and feet - namely 'megaly' of the acral parts. When fully expressed the protruding jaw, thick lips, overly large tongue, and accentuated orbit and frontal ridges can be recognised at a distance
Other features include:
- headache - this is an early feature and is due to the skull enlargement and stretching of the dura mater.
- metabolic changes may also be present, among which are glucose intolerance (30%) (and sometimes overt diabetes mellitus (10%)), and hypertension (15%).
- cutaneous manifestations include:
- skin may be leathery and furrowed
- seborrhoea, acne
- soft tissue hypertrophy eg causing carpal tunnel syndrome
- skin tags in the axillae (molluscum fibrosum which are non-tender skin coloured protrusions)
- hirsutism, excessive sweating
- acanthosis nigracans
- may be a proximal myopathy. Also acromegaly is one of the causes of thickened peripheral nerves.
- enlarged organs - heart, liver, thyroid
- libido is reduced - due to impaired gonadotrophin secretion and/or associated hyperprolactinoma