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Clinical Summary

Abdominal striae are linear, depressed, pink or bluish scar-like lesions that may later become silver or white. They are caused by weakening of the elastic cutaneous tissues from chronic stretching. They most commonly occur on the abdomen but are also seen on the buttocks, breasts, axilla, and thighs. Striae are commonly seen in obesity, pregnancy, rapid growth associated with puberty, Cushing syndrome, and chronic topical corticosteroid treatment.

Management and Disposition

This finding seldom presents as a condition requiring acute treatment; thus, attention is directed to determining and treating the underlying cause.


  1. Recent striae with moon facies, hypertension, renal calculi, osteoporosis, and psychiatric disorders are suggestive of Cushing syndrome.

  2. The striae color (red/purple) caused by pregnancy typically fades with time, unlike striae associated with Cushing syndrome.

  3. Inappropriate use of topical corticosteroids can result in permanent striae.

FIGURE 13.131

Abdominal Striae. These striae are seen in a patient with recent weight gain, moon facies, and altered mental status. The patient was diagnosed with Cushing syndrome.

FIGURE 13.132

Abdominal Striae. Obese patient with lower lateral wall striae. Also noted is thickened, hyperpigmented, abdominal skin, typical of acanthosis nigricans (associated with diabetes). (Photo contributor: J. Matthew Hardin, MD.)

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