What are the signs of possible hypercortisolism in a patient undergoing steroid treatment?

The signs of possible hypercortisolism, or Cushing's syndrome, are indeed represented by all the options listed. Each symptom reflects the physiological effects of elevated cortisol levels due to steroid treatment.

Thinning hair can occur as a result of hormonal changes influenced by elevated cortisol, which can lead to hair loss or changes in hair growth patterns. This is an important sign to note in patients receiving steroid therapy.

Darkened skin may also be observed in these patients, particularly in areas of friction or those subjected to pressure. This hyperpigmentation is linked to the influence of cortisol on melanocyte activity, although it may be less common.

A puffy face, often referred to as "moon facies," is a hallmark sign of hypercortisolism. This swelling results from the redistribution of fat and fluid retention that can occur with high levels of cortisol.

Because all these signs are associated with elevated cortisol levels, selecting the answer that encompasses all of them provides a comprehensive understanding of the manifestations of hypercortisolism in the context of steroid treatment.