Striated skin atrophy: causes, symptoms, diagnosis, treatment

Stripe atrophy of the skin (syn. stripe atrophoderma) is a unique skin atrophy in the form of narrow, wavy, sunken stripes.

The causes and pathogenesis of stripe-like skin atrophy have not been established.

Symptoms of striae atrophia. As a rule, in places subject to increased stretching, symmetrically located, superficial, slightly elevated strip-shaped foci of atrophy with a finely folded surface, several centimeters long, about 5 mm wide on average, appear. At first, these foci are livid-red, then the color changes to grayish-white, they flatten, become slightly sunken. More often develops in females, especially during puberty or pregnancy, as well as in obese individuals. Stretch marks that occur during puberty are located mainly on the thighs, buttocks, mammary glands; in boys - on the thighs and lumbosacral region; during pregnancy - on the skin of the abdomen and mammary glands. In obesity, Itsenko-Cushing's disease, there may be other localizations, in rare cases in the shoulder girdle and even on the face. The process is irreversible.

Pathomorphology. At the initial stage, an inflammatory reaction is detected in the form of predominantly lymphocytic infiltration around the vessels. At a later stage, thinning of the epidermis and dermis, rarefaction and disappearance of elastic fibers in the center of the lesion are noted, while along its periphery they look like dense lumps and curls. In old lesions, as a result of regeneration, collagen fibers are located parallel to the epidermis, mixing with a large number of thin elastic fibers. However, P. Zheng et al. (1985) did not find structural changes in the elastic fibers. With scanning electron microscopy, they revealed a dense network of these fibers, undetectable with conventional staining, apparently due to the fact that immature fibers contain an insufficient amount of protein matrix. This, combined with the location of collagen fiber bundles parallel to the skin surface, according to the authors, confirms the point of view of H. Pincus et al. (1966) that striae are scars. It is assumed that the formation of fibrous structures is a reflection of the reparative process after their destruction caused by inflammation at a very early stage of striae formation.

Histogenesis. A significant role in the development of this type of atrophy is attributed to disorders in the pituitary-adrenal cortex system. Based on this, W. Hauser (1958) considers it a monosymptom of Itsenko-Cushing's disease. Moreover, striae can also develop from local application of corticosteroids. Mechanical factors are also important, which is observed with rapid weight gain or weight loss, as well as with lifting weights. Linear skin atrophy occurs as a symptom of Marfan's disease, in which not only elastic but also collagen fibers undergo changes.

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