Striae Distensae (Stretch Marks) Workup

Updated: Feb 22, 2022
  • Author: Samer Alaiti, MD, RVT, RPVI, FACP; Chief Editor: William D James, MD  more...
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Histologic Findings

In the early stages, inflammatory changes may predominate; edema is present in the dermis along with perivascular lymphocyte cuffing.

In the later stages, the epidermis becomes thin and flattened with loss of the rete ridges. The dermis has thin, densely packed collagen bundles arranged in a parallel array horizontal to the epidermis at the level of the papillary dermis. Elastic stains show breakage and retraction of the elastic fibers in the reticular dermis. The broken elastic fibers curl at the sides of the striae to form a distinctive pattern.

Scanning electron microscopy shows extensive tangles of fine, curled elastic fibers with a random arrangement. This arrangement is in contrast to normal skin, which has thick, elastic fibers with a regular distribution. When viewed by transmission electron microscopy, the ultrastructure of elastic and collagen fibers in striae is similar to that of healthy skin.