Striae gravidarum

Striae are atrophic linear plaques, most often found on the breasts, abdomen, hips, and thighs. They develop in a variety of circumstances, some of which involve physical stretching of the skin, such as adolescent growth spurts, and during hormonal changes, such as Cushing's syndrome. It has been suggested that genetics may play a role in their development. Regardless of the etiology, all striae display the same histological changes in the dermis showing atrophy and loss of rete ridges. These findings are similar to those seen with scar formation. At present, no definitive treatments have been established.     

Striae gravidarum in primiparae

BACKGROUND: Striae distensae are widely known to occur in pregnancy and aesthetically they can be a cause of great concern for many women. Various factors have been reported to be associated with the development of striae but the results are conflicting. OBJECTIVES: To observe the prevalence of striae gravidarum in primiparae and identify independent associated risk factors. METHODS: An observational analysis of 324 primiparae was conducted within 48 h of delivery. Data was collected in the form of a questionnaire and physical examination. Seventy-two primiparae participated in a pilot study in 1999 and the remaining were assessed over a 4-month period in 2000. Seventeen variables were recorded, and striae graded according to quantity and severity. Fifteen primiparae were excluded prior to analysis. RESULTS: Fifty-two per cent (161 of 309) of primiparous white women had striae of which 12% (20 of 161) were classified as severe. The most significant risk factor was low maternal age (P < 0.0001). Twenty per cent (14 of 71) of teenagers had severe striae, a finding not seen in women over 30 years of age. Other significant risk factors included maternal body mass index greater than 26 (P = 0.0003), maternal weight gain of more than 15 kg (P = 0.0121) and high neonatal birth weight (P = 0.0135). CONCLUSIONS: Logistic regression analysis demonstrated that maternal age, body mass index, weight gain and neonatal birth weight were independently associated with the occurrence of striae. It appears that the group at highest risk of developing severe striae are teenagers. This finding is important and may provide impetus to explore the pathomechanisms of striae.     

Striae gravidarum: associated factors

BACKGROUND: Striae gravidarum (SG) is the most common change in connective tissue of pregnant women and may cause cosmetic concerns. OBJECTIVES: To determine the frequency of SG in Iranian pregnant women and its possible associations with the characteristics of themselves and their newborns. METHODS: One hundred and eighteen primigravid pregnant women were included in this prospective observational study at their first prenatal visit, among them 114 completed the study and gave birth. RESULTS: One hundred (87.7%) of 114 women developed SG with a mean Davey's score of 4.04 +/- 2.47. The mean gestational age at which SG first appeared was 27.57 +/- 5.38 weeks. Family history of SG in mother, baseline and delivery body mass index, greatest abdominal and hip girths, newborn weight, height and head circumference were significantly associated with the presence of SG. All of these factors were also correlated with Davey's score. CONCLUSION: Genetic and physical risk factors may be involved in the development of SG in primigravid women.     

Striae cutis distensae und Hypophysentumor

Ohne Zusammenfassung     

Striae distensae after tension-requiring skin sutures

Three cases of striae distensae which developed along suture scars after skin surgery were described. The production of striae should be taken into consideration in surgery of the skin, especially in young woman.     

Fractional Photothermolysis for the Treatment of Striae Distensae in Asian Skin

Background:Striae distensae (SD) are dermal scars characterized by linear atrophic depressions. Fractional photothermolysis (FP) is an effective modality for the treatment of cutaneous scars. Objective:To evaluate the safety and efficacy of FP for the treatment of SD in Asian skin. Methods:Six female volunteers aged between 20 and 35 years with chronic striae albae phase SD on both buttocks were enrolled. SD lesions on the right buttock were irradiated with a 1550-nm FP laser and patients were followed every 4 weeks for a total of 8 weeks. Outcome assessments included serial photographs, erythema index and melanin index tracking, skin elasticity, histologic examination, and the patients’ subjective satisfaction scores. Results:FP treatment was associated with a substantial improvement in the appearance of SD at 8 weeks post-treatment. The erythema index and melanin index of the treated SD lesions tended to converge with those of the control skin at 4-week follow-up. Skin elasticity was found to be partially normalized after FP. In addition, there was a significant increase in epidermal thickness, collagen, and elastic fiber deposition after FP as demonstrated by histologic examination. Adverse effects of FP included mild and transient pain and hyperpigmentation. Conclusion:FP can reduce SD by stimulating new collagen and elastic fiber synthesis. In addition, repetitive treatments might constitute an effective approach to improving the treatment of SD.     

Striae distensae in darker skin types: the influence of melanocyte mechanobiology

Introduction Striae distensae in White people are commonly described as being reddish at first and turning white in time. This dual perception has been challenged. Indeed, the color difference between striae distensae and their surrounding skin varies on a wide range in part depending upon typology. Aim To study striae nigrae that are found only in subjects of darker complexion. Materials and methods In the present study conducted in 44 darker skin adults, dermoscopy was combined to reflectance colorimetry. Results Striae nigrae exhibited hypermelanosis of the epidermal rete ridges crossing transversally the lesions in a laddering pattern. By contrast, striae albae showed only faint melanotic networks. Conclusions As striae distensae are in part under the influence of skin stretching, their colors are likely to be controlled by some mechanobiological process activating or inhibiting melanogenesis in people of darker complexion. No argument involving an inflammatory mechanism is supported by the present observations.     

Striae cutis atrophicae. Morphokinetic examinations in vitro.

The in vitro behaviour of fibroblasts and epidermis cells taken from recently developed striae distensae was studied in morphokinetic examinations in the cell culture and the results were discussed. The findings give rise to the assumption that the antianabolous effects of the adrenocorticotrophic hormones do not only indirectly cause the atrophia of the epidermis by decrease of the elasticity of the connective tissue, but it appears that primarily epidermis and corium are simultaneously involved in the pathomechanisms of these alterations by irreversible cellular damage.     

Two Cases of Linear Focal Elastosis (Elastotic Striae)

Linear focal elastosis (LFE) or elastotic striae was first described by Burket in 1989 in three elderly men. They presented with striae-like yellow palpable bands on their backs. Burket described many fine wavy bundles of elastic fibers separating the collagen in the middle to reticular dermis under microscopic examination. Until recently, there have been about 14 reported cases of LFE; elderly males are predominant. We encountered two Korean teen-aged males with linear, reddish, palpable bands and some atrophic bands across their backs. Histopathological examination revealed that elastosis was not as prominent as in previously reported cases. Our cases might represent early-evolving LFE.     

Striae and acne following cardiac surgery in a child

We report a 13-year-old girl with extensive striae and an acneiform eruption following surgery for complex congenital heart disease. These findings were associated with elevated serum and urinary cortisol levels with loss of diurnal rhythm. The resolution of the eruption and the fading of her striae coincided in time with normalization of her blood parameters on day 72 postoperatively. We conclude that the cause of steroid excess in our patient was stress induced by the cardiac surgery and a complicated and protracted postoperative course. To our knowledge, this is the first report in the English language literature of skin changes due to endogenous hypercortisolaemia caused by intense physical and emotional stress.     

Striae distensae of pregnancy. An in vivo biomechanical evaluation

Background and objective Striae distensae of pregnancy is a common finding. There is currently a lack of information about the rheological characteristics of such lesions. The purpose of this study was to compare the mechanical properties of striae distensae before and after delivery. Patients and methods A total of 79 primigravid entered the study. Rheological properties of skin were evaluated in vivo using a Cutometer® equipped with a 2-mm probe. Results Mechanical properties of striae distensae developing during pregnancy resembled those of the surrounding skin. By contrast, significant differences were yielded during post-partum. Extensibility of striae distensae was increased although parameters of elasticity remained normal. Conclusions Rheological properties of striae distensae of pregnancy vary in time. This might reflect the changes in hormones and in the mechanical stresses normally setting the skin under tension.