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Striae in Adult
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Striae in Adult

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Contributors: Daniel Yanes MD, Susan Burgin MD
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Synopsis

Striae : Linear configuration
Striae (striae distensae), or stretch marks, are common in all ages 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), training with 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%. The skin findings themselves are rarely symptomatic, but they may occasionally indicate an underlying disease state (such as Cushing syndrome). In Marfan syndrome, striae are seen in around two-thirds of patients. Striae tend to flatten and become less conspicuous over time.

Bevacizumab, a vascular endothelial growth factor (VEGF) inhibitor, has been reported to cause ulceration of striae that have been induced by concurrent systemic glucocorticoid therapy.

Related topic: drug-induced skin ulcers

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 presents 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 border.
  • Steroid atrophy may accompany striae caused by topical corticosteroids.
  • 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 Reviewed:09/22/2019
Last Updated:09/17/2020
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Striae in Adult
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A medical illustration showing key findings of Striae : Linear configuration
Clinical image of Striae - imageId=848847. Click to open in gallery. caption: 'Multiple brown, curvilinear and linear, atrophic plaques with a rippled appearance on the abdomen of a pregnant patient.'
Multiple brown, curvilinear and linear, atrophic plaques with a rippled appearance on the abdomen of a pregnant patient.

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