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Striae Distensae

Stretch Mark


Presentation

  • A 17-year-old girl with systemic lupus erythematosus presented with painful edematous abdominal striae. She had been treated with systemic steroid for the systemic lupus erythematosus.[ncbi.nlm.nih.gov]
Rigor
  • There is a clear need for robust, methodologically rigorous randomised trials involving larger sample sizes to evaluate the effects of topical preparations on the development of stretch marks in pregnancy.[ncbi.nlm.nih.gov]
  • Furthermore, available topical modalities generally lack strong evidence from rigorous, well‐designed, randomized controlled trials with ample numbers of subjects.[doi.org]
Tall Stature
  • CONCLUSION: Our results indicate that horizontal striae distensae of the lower back in adolescent boys is associated with a rapid growth spurt, tall stature, and family history of striae distensae.[ncbi.nlm.nih.gov]
Ecchymosis
  • Other changes seen were oral lesions seen in 46% cases, yellowish discoloration of skin seen in 40% cases, pruritis seen in 45% cases, striae distensae seen in 36% cases, Taenia infection was seen in 29% cases, Petechiae, ecchymosis and bruising were[medical-dictionary.thefreedictionary.com]
Low Back Pain
  • Demet Kokanal and Ali Turhan Çağlar, Hidden association between the presence and severity of striae gravidarum and low back pain in pregnancy, European Journal of Obstetrics & Gynecology and Reproductive Biology, 10.1016/j.ejogrb.2018.12.004, (2018).[doi.org]
Back Pain
  • Demet Kokanal and Ali Turhan Çağlar, Hidden association between the presence and severity of striae gravidarum and low back pain in pregnancy, European Journal of Obstetrics & Gynecology and Reproductive Biology, 10.1016/j.ejogrb.2018.12.004, (2018).[doi.org]
Eczema
  • […] striae distensae, click HERE ) Systemic steroids are known to induce purplish stretch marks as part of Cushing’s syndrome ( more HERE ) Topical steroids have anti-inflammatory action and are used in the treatment of inflammatory skin diseases such as eczema[genevadermatology.ch]
  • Relapsing polychondritis 673 211 Rhinophyma 677 212 Rocky Mountain spotted fever and other rickettsial infections 679 213 Rosacea 684 214 Sarcoidosis 692 215 Scabies 697 216 Scleredema 700 217 Scleroderma 703 218 Sebaceous hyperplasia 707 219 Seborrheic eczema[books.google.de]
  • Ehlers-Danlos syndrome, or Marfan’s syndrome growth spurt in puberty rapid weight loss or gain weight training with rapid muscle growth If you use corticosteroid creams for an extended time period, such as prescription-strength hydrocortisone to treat eczema[healthline.com]
  • […] to Van Scott and Yu discloses the use of alpha hydroxy acids for treatment of skin irritating or scalp related conditions, such as dry skin, ichthyosis, hyperkeratosis, dandruff, Darier's disease, lichen simplex chronicus, keratoses, acne, psoriasis, eczema[patents.google.com]
Koebner Phenomenon
  • Koebner phenomenon, the appearance of preexisting skin lesions following trauma to previously uninvolved skin, has been seen frequently with vitiligo.[ncbi.nlm.nih.gov]
  • Clindamycin-induced Maculopapular Exanthema with Preferential Involvement of Striae Distensae: A Koebner phenomenon? Acta Dermatovenerol Croat. 2018;26:61-3. Happle R, Kluger N.[adc.mef.hr]
  • Koebner’s phenomenon in vitiligo: European position paper. Pigment Cell Melanoma Res 2011;24:564-73. 2. van Geel N, Speeckaert R, De Wolf J, Bracke S, Chevolet I, Brochez L et al. Clinical significance of Koebner phenomenon in vitiligo.[pigmentinternational.com]
Cutaneous Manifestation
  • To the best of our knowledge, this cutaneous manifestation of lupus erythematosus has not been previously reported. Koebner's phenomenon is suspected to be the underlying mechanism.[ncbi.nlm.nih.gov]
  • Volc-Platzer, Hautmanifestationen beim metabolischen Syndrom Cutaneous manifestations of metabolic syndrome, Der Hautarzt, 10.1007/s00105-016-3891-2, 67, 12, (982-988), (2016).[doi.org]
Large Breast
Hyperactivity
  • Poidevin 1959 proposed the existence of a 'striae factor' for each woman and while not identifying what this 'striae factor' may be, he found a clear relationship between the reduced glucose tolerance in pregnancy, a sign of adrenocortical hyperactivity[doi.org]

Workup

  • In patients presenting with striae distensae due to pubertal growth ’spurt’, increase in weight, pregnancy, and/or corticosteriod abuse, no further workup is required.[dermatologyadvisor.com]
Bartonella Henselae
  • None of the boys had a history of unmonitored exogenous steroid use or prior infection with Bartonella henselae or Borrelia burgdorferi. Only one (8.3%) had a chronic medical condition.[ncbi.nlm.nih.gov]
Borrelia Burgdorferi
  • None of the boys had a history of unmonitored exogenous steroid use or prior infection with Bartonella henselae or Borrelia burgdorferi. Only one (8.3%) had a chronic medical condition.[ncbi.nlm.nih.gov]

Treatment

  • Lesions were randomized to receive treatment, with site-matched normal control areas. Patients received a total of 6 treatments using a 1550-nm, erbium-doped fiber laser with 2 to 3 weeks of elapsed time between treatments.[ncbi.nlm.nih.gov]

Prognosis

  • Abstract Full HTML Article PDF ecancer 11 756 / Case Report Glioblastoma cerebri is a rare paediatric malignancy with dismal prognosis [Chappé C, Riffaud L, and Tréguier C et al (2013) Primary gliomatosis cerebri involving gray matter in pediatrics: a[ecancer.org]
  • What is the prognosis of stretch marks? As the striae mature, they become less apparent but they rarely disappear. They do not cause any health problems.[medicinenet.com]
  • Prognosis Striae distensae are usually a cosmetic problem; however, if extensive, they may tear and ulcerate when an accident or excessive stretching occurs. Adolescents with striae can expect their striae to be less visible with time.[emedicine.com]

Etiology

  • The experience of 20 patients with striae distensae of varying etiologies and the treatment with topical tretinoin is described. Of the 16 patients who completed the study, 15 had significant improvement in their clinical picture.[ncbi.nlm.nih.gov]
  • […] and Pathophysiology Specific etiology of SD is unknown.[unboundmedicine.com]
  • One of four possible etiologic mechanisms usually considered were: (1) insufficient development of the integuement, including a deficiency in its elastic properties; (2) rapid stretching of the skin; (3) endocrine imbalance; and (4) other, possibly toxic[jamanetwork.com]
  • A number of key etiological theories have been postulated, including: Inadequate development of elastic fibers and collagen in the skin Endocrine imbalance and physical stretching of the skin due to increased size of any part of the body ex.[dermclub.org]
  • There are many clinical situations in which striae arise, and this variability has contributed to the confusion of their etiology.[randyjacobsmd.com]

Epidemiology

  • EPIDEMIOLOGY AND RISK FACTORS Epidemiologic data on striae distensae in the general population are limited [ 1-11 ]. Reported incidences have ranged from as low as 11 percent in normal men to up to 88 percent in pregnant females [ 5,11 ].[uptodate.com]
  • To better characterize the epidemiological factors associated with SG. An anonymous survey administered at Stanford Ambulatory Clinics sampled 161 women who had given birth.[ncbi.nlm.nih.gov]
  • Risk factors have been reported but much remains to be understood about their epidemiology, diagnosis and treatment.[onlinelibrary.wiley.com]
  • Pregnancy Considerations Common finding on the abdomen, breast, and thighs of pregnant women, especially during the 3rd trimester—called striae gravidarum Epidemiology Incidence Incidence range of 43–88% for women during pregnancy ( 1 ) Prevalence Adult[unboundmedicine.com]
Sex distribution
Age distribution

Pathophysiology

  • BACKGROUND: Despite the high prevalence of striae distensae, clinical studies are few in number, and their pathophysiology still obscure.[ncbi.nlm.nih.gov]
  • This chapter will address the pathophysiology and risks associated with the development of striae in the context of the above conditions as well as review preventive measures and known treatments.[miami.pure.elsevier.com]
  • Etiology Pathophysiology Striae distensae results from cracks in the connective tissue forming atrophic dermal scars underneath an atrophic epidermal layer. The pathophysiology of striae distensae is not fully understood.[dermatologyadvisor.com]

Prevention

  • Finally, cocoa butter and olive oil are not effective for preventing SG or reducing the severity of lesions. We conclude that reliable methods for preventing SG are scarce.[doi.org]
  • Fletcher and Marvin Reid, Prevention of striae gravidarum with cocoa butter cream, International Journal of Gynecology & Obstetrics, 108, 1, (65-68), (2009).[dx.doi.org]

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