Dermoscopy of Striae Rubrae

A 16-year-old male patient presented with striae rubrae over his abdomen, back, upper arms, and thighs [Figure 1]. The lesions had developed in the last 2 years since joining a gymnasium, most likely stemming from periodic gain and loss of weight. There was no suggestion of any other significant skin or systemic disease or use of topical or systemic corticosteroids. Laboratory investigations including serum cortisol were within normal limits.

Figure 1.

Striae rubra over the abdomen

Dermoscopy (polarized light 10×, Dermlite ® foto ii pro) showed linear vessels and dotted vessels over a faint violaceus background. The linear vessels were arranged both along and perpendicular to the long axis of the striae. There was no evidence of significant pigmentary alteration on dermoscopy [Figure 2].

Figure 2.

Dermoscopy showing linear vessels and dotted vessels (red arrow) with a faint violaceus background. The linear vessels are arranged both along (green arrow) the long axis of the striae and perpendicular to the long axis of the striae (black arrow) (polarized light ×10, Dermlite ® foto ii pro)

The different colors of striae during different evolutionary stages are considered to be the outcome of a combination of vascular and pigmentary patterns. Striae rubrae are characterized by vasodilation possibly secondary to angiogenesis.[1] The dermoscopy of striae rubrae has been reported to show linear vessels oriented at right angles to the axis of the striae,[1] which was also observed in our case. In addition, we observed linear vessels along the axis of the striae and many scattered dotted vessels over a faint violaceous background. It is possible that angiogenesis might be occurring at a more deeper level, explaining the violaceus background. However, the main limitation in our case is the absence of histopathology, without which we cannot comment on this aspect. We hypothesize that the presence of different vessels oriented both parallel and perpendicular to the axis of the striae suggests the ongoing stage of angiogenesis. Subject to further confirmation of these dermoscopic features of striae rubra and larger follow-up studies, we believe that dermoscopy may serve as a non-invasive tool to assess the treatment response in striae.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.