Striae Distensae Differential Diagnoses

  • Author: Samer Alaiti, MD, RVT; Chief Editor: William D James, MD   more...
 
Updated: Aug 17, 2011
 
 

Diagnostic Considerations

Although the diagnosis of striae is usually straightforward, the rare possibility of Cushing syndrome must be entertained. In the latter, striae are characterized by their inordinate breadth, depth, and intense color.

In linear focal elastosis (elastotic striae), asymptomatic, yellow linear bands arrange themselves horizontally over the lower back. These lesions may resemble striae distensae, but they are palpable rather than depressed and yellow rather than purplish or white.

Proceed to Workup
 
 
Contributor Information and Disclosures
Author

Samer Alaiti, MD, RVT  Clinical Associate Professor, Department of Dermatology, Keck School of Medicine of the University of Southern California; Medical Director, Miracle Mile Medical Center for Dermatology and Cosmetic Surgery, Inc

Samer Alaiti, MD, RVT is a member of the following medical societies: American Academy of Cosmetic Surgery, American Academy of Dermatology, American College of Phlebology, American College of Physicians-American Society of Internal Medicine, American Society for Dermatologic Surgery, American Society for Laser Medicine and Surgery, and American Society of Lipo-Suction Surgery

Disclosure: Nothing to disclose.

Specialty Editor Board

Barbara R Reed, MD  Clinical Professor, Department of Dermatology, Dermatology Service, Denver Veterans Affairs Medical Center, University of Colorado Health Sciences Center; Consulting Staff, Denver Skin Clinic

Disclosure: Nothing to disclose.

Richard P Vinson, MD  Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association

Disclosure: Nothing to disclose.

Lester F Libow, MD  Dermatopathologist, South Texas Dermatopathology Laboratory

Lester F Libow, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, and Texas Medical Association

Disclosure: Nothing to disclose.

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

William D James, MD  Paul R Gross Professor of Dermatology, University of Pennsylvania School of Medicine; Vice-Chair, Program Director, Department of Dermatology, University of Pennsylvania Health System

William D James, MD is a member of the following medical societies: American Academy of Dermatology and Society for Investigative Dermatology

Disclosure: Elsevier Royalty Other

Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author, Zein E. Obagi, MD, to the development and writing of this article.

References
  1. Kang S, Kim KJ, Griffiths CE, Wong TY, Talwar HS, Fisher GJ, et al. Topical tretinoin (retinoic acid) improves early stretch marks. Arch Dermatol. May 1996;132(5):519-26. [Medline].

  2. Goldfarb MT, Ellis CN, Weiss JS, Voorhees JJ. Topical tretinoin therapy: its use in photoaged skin. J Am Acad Dermatol. Sep 1989;21(3 Pt 2):645-50. [Medline].

  3. Kligman A. Topical tretinoin: indications, safety, and effectiveness. Cutis. Jun 1987;39(6):486-8. [Medline].

  4. Goldberg DJ, Marmur ES, Schmults C, et al. Histologic and ultrastructural analysis of ultraviolet B laser and light source treatment of leukoderma in striae distensae. Dermatolog Surg. 2005;31(4):385-7. [Medline].

  5. Fox JL. Pulse dye laser eliminates stretch marks. Cosmetic Dermatology. 1997;10:51-2.

  6. Jimenez GP, Flores F, Berman B, Gunja-Smith Z. Treatment of striae rubra with the 585-nm pulsed-dye laser. Dermatol Surg. 2003;29(4):362-5. [Medline].

  7. McDaniel DH, Ash K, Zukowski M. Treatment of stretch marks with the 585-nm flashlamp-pumped pulsed dye laser. Dermatol Surg. Apr 1996;22(4):332-7. [Medline].

  8. McDaniel DH. Laser therapy of stretch marks. Dermatol Clin. 2002;20:67-76. [Medline].

  9. Suh DH, Chang KY, Son HC, Ryu JH, Lee SJ, Song KY. Radiofrequency and 585-nm pulsed dye laser treatment of striae distensae: a report of 37 Asian patients. Dermatol Surg. Jan 2007;33(1):29-34. [Medline].

  10. Goldman A, Rossato F, Prati C. Stretch marks: treatment using the 1,064 nm Nd:YAG. laser. Dermatol Surg. May 2008;34(5):686-91.

  11. Hernandez-Perez E, Colombo-Charrier E, Valencia-Ibiett E. Intense pulsed light in the treatment of striae distensae. Dermatol Surg. 2002;28(12):1124-30. [Medline].

  12. Kim BJ, Lee DH, Kim MN, Song KY, Cho WI, Lee CK, et al. Fractional photothermolysis for the treatment of striae distensae in Asian skin. Am J Clin Dermatol. 2008;9(1):33-7.

  13. Obagi ZE, Obagi S, Alaiti S, Stevens MB. TCA-based blue peel: a standardized procedure with depth control. Dermatol Surg. Oct 1999;25(10):773-80. [Medline].

  14. Alexiades-Armenaka M, Sarnoff D, Gotkin R, Sadick N. Multi-center clinical study and review of fractional ablative CO2 laser resurfacing for the treatment of rhytides, photoaging, scars and striae. J Drugs Dermatol. Apr 2011;10(4):352-62. [Medline].

  15. Arnold HL, Odom RB, James WD. Abnormalities of dermal connective tissue. In: Odom RB, James WD, Berger TG, eds. Andrew's Diseases of the Skin Clinical Dermatology. 9th ed. Philadelphia, Pa: WB Saunders; 2000:645-6.

  16. Burton Jl, Lovell CR. Disorders of connective tissue. In: Champion RH, Wilkinson DS, Ebling FJG, et al, eds. Textbook of Dermatology. 6th ed. London, England: Blackwell Science; 1998:2008-9.

  17. Dover JS. Sports dermatology. In: Fitzpatrick TB, Eisen AZ, Wolff K, Freedberg IM, eds. Dermatology in General Medicine. 4th ed. New York, NY: McGraw-Hill; 1993:1618-19.

  18. Medical Economics Staff. Physician's Desk Reference. 53rd ed. Montvale, NJ: Medical Economics Company; 1999:2177.

Previous
Next
 
Mature striae distensae on the abdomen following pregnancy (lesions present for 18 y).
Significant improvement following 3 consecutive blue peels (20% trichloroacetic acid to the level of the papillary dermis) completed at 6-week intervals.
Striae distensae on the thigh.
Striae distensae after treatment with topical tretinoin 0.1% cream for 3 months and 2 treatments with the flashlamp pulsed dye laser.
Mature striae distensae on the abdomen secondary to pregnancy (lesions present for 21 y).
Significant improvement is achieved using tretinoin 0.1% daily for 8 weeks.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.