Striped skin atrophy: causes, symptoms, diagnosis, treatment

Skin atrophy is striped (blue striped atrophodermia) - a kind of atrophy of the skin in the form of narrow wavy, sunken bands.

Causes and pathogenesis of stratiform skin atrophy are not established.

Symptoms of skin atrophy of the striped. As a rule, in areas subject to increased stretching, symmetrically located, superficial, slightly elevated strip-shaped foci of atrophy with a shallow-folded surface, several centimeters long, about 5 mm wide on average, appear. Initially, these foci are of a reddish color, then the color changes to grayish white, they flatten, they become slightly sunken. It often develops in women, especially during puberty or during pregnancy, as well as in obese people. The striae that arise during puberty are located mainly on the hips, buttocks, mammary glands; in boys - on the hips and lumbosacral area; during pregnancy - on the skin of the abdomen and mammary glands. With obesity, Izenko-Cushing's disease can be other localizations, in rare cases in the shoulder girdle and even on the face. The process is irreversible.

Pathomorphology. In 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 is noted, rarefaction and disappearance of elastic fibers in the center of the focus, while at the periphery of it they look like dense lumps and curls. In old foci, 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) found no structural changes in the elastic fibers. In scanning electron microscopy, they detected a dense network of these fibers, which is not detectable in normal color, apparently because the immature fibers contain an insufficient amount of protein matrix. This, combined with the arrangement of bundles of collagen fibers parallel to the skin surface, according to the authors, confirms the point of view of N. Pincus et al. (1966) that striae are scars. It is suggested that the new formation of fibrous structures is a reflection of the reparative process after their destruction, caused by inflammation at a very early stage of stria formation.

Histogenesis. A significant role in the development of this type of atrophy is attributed to disturbances in the pituitary-adrenal gland system. Proceeding from this, W. Hauser (1958) regards it as a monosymptom of Itenko-Cushing's disease. Moreover, striae can also develop from topical application of corticosteroids. There are also important mechanical factors, which is observed with a rapid increase in body weight, or with weight loss, as well as when lifting weights. Linear atrophy of the skin occurs as a symptom of Marfan's disease, in which not only elastic but also collagen fibers are subjected to changes.

[1], [2], [3]