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Striae in Adult
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Striae in Adult

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Contributors: Noah Craft MD, PhD, Lindy P. Fox MD, Lowell A. Goldsmith MD, MPH
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Synopsis

Striae (striae distensae), or stretch marks, are due to thinning or atrophic defects in the dermis, typically in areas of repeated or prolonged skin stretching. The etiology likely involves the interplay of mechanical stress, hormones, and genetics. Striae are commonly located on the abdomen, thighs, and buttocks, or in areas where the skin stretches excessively. Striae are slightly more common in light skin phototypes and are twice as common in females.

Periods of rapid growth, such as puberty, pregnancy (striae gravidarum), weight lifting, rapid weight gain, and adolescent growth spurts, are common triggers. Striae also commonly occur in the setting of obesity. As 60%-70% of the US population is labeled as overweight or obese, the prevalence of striae from obesity is estimated at 40%. Since obesity is more common in African-American, Hispanic, and Native American patients, striae are frequently encountered in darker skin phototypes. Striae occurring on the abdomen and breasts are common in pregnancy. The skin findings themselves are only of cosmetic concern, but they may indicate an underlying disease state (such as Cushing syndrome). Striae tend to flatten and become less conspicuous over time.

Codes

ICD10CM:
L90.6 – Striae atrophicae

SNOMEDCT:
201066002 – Skin striae

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Anetoderma is caused by focal loss of elastic fibers within the dermis and present as flaccid, well-circumscribed areas of slack skin. Sac-like protrusions can occasionally be observed in some lesions.
  • Lichen sclerosus presents as flat, yellowish-white plaques surrounded by a red, purple, or violet-colored border.
  • Steroid atrophy
  • Scars are raised, firm nodules or plaques at sites of previous trauma.
  • Linear focal elastosis (elastotic striae) is a rare condition that presents as asymptomatic atrophic yellow lines on the mid- or lower back, thighs, arms, or breasts.

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Updated: 02/16/2018
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Striae in Adult
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Striae : Abdomen, Atrophy, Breast, Buttocks, Erythema, Linear configuration, Lower back, Thigh, Striae
Clinical image of Striae
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