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Background: Striae gravidarum are a common occurrence in pregnancy and many women use a topical product to prevent their development or lessen their appearance if they do develop. There is a lack of evidence on the effectiveness of many of the products used by women. This study arose from challenges in recruitment to a pilot randomised trial (ISRCTN trial registration number:76992326) designed to evaluate the feasibility of a definitive trial to compare a moisturising oil to no treatment in the prevention and reduction in severity of striae gravidarum. The study reported here explored the factors influencing recruitment to that pilot trial.Methods: A qualitative descriptive study was undertaken involving primigravid women attending an Irish maternity hospital. Data were collected by semi-structured telephone interviews over a four-week period and analysed using the framework method of analysis. Fifteen interview transcripts were included in the analysis.Results: Four main themes consisting of twelve categories were identified from the interview data. The themes focused on women's prevention of stretch marks and their choice of anti-stretch mark product, who and what influenced that choice and influences on trial participation. In relation to influences on trial participation, the possibility of being randomised to the non- intervention or control group was a deterrent for many women.Conclusions: The prevention of stretch marks is important to pregnant women, as is their choice of product to prevent them. Offering women the opportunity to be part of a trial that would be of low burden and would test a well-known product may optimise recruitment. However, reluctance to be randomised because of the possibility of being allocated to the non-intervention control group suggests that further work is needed in this field on how best to communicate uncertainty to potential participants. [ABSTRACT FROM AUTHOR]

Striae distensae (SD) cause a cosmetic problem to many patients. Recently, fractional micro-needle radiofrequency (FMR) device has been introduced in treatment of SD. Also, fractional CO2 laser has been used as a resurfacing laser technique in the treatment of SD. The aim of our study was to assess and compare between the efficacy of FMR and fractional CO2 laser in treatment of SD. Seventeen female patients with SD were enrolled in this study. Detailed history was taken and dermatological examination was done to determine the type of striae, the location, and measurement of the width of the largest striae on each side. In each patient, one side was randomly assigned to treatment by FMR (area A), and the other side to treatment by fractional CO2 laser (area B). Our results showed that both techniques were effective. A slight better efficacy was encountered with FMR, but the difference was not statistically significant (p = 0.716). The current study concluded that FMR and fractional CO2 laser are almost equally effective in the treatment of SD (rubra and alba). Development of post inflammatory hyper-pigmentation (PIH) was evident with fractional CO2 in contrast with FMR, and the difference was statistically significant (p = 0.001). [ABSTRACT FROM AUTHOR]

Objective: Stretch marks are disfiguring skin lesions that often cause problems of self‐esteem, but little effort has been put to studying this pathology. We therefore analysed cell cultures of dermal fibroblasts isolated from a striae albae, to thereafter reconstruct a full thickness skin model. Methods: Human Dermal Fibroblasts (HDF) were isolated from a striae distensae (SD) lesion and from the adjacent non‐lesioned skin. The dermis of two full thickness skin models was reconstructed with either striae‐ or normal‐HDF, while the epidermis was in both reconstructed with Normal Human Epidermal Keratinocytes. Results: Main observations and pertinent data: Gene expression analysis of cell cultures revealed a generalized decomposition of the Extra Cellular Matrix (ECM), since collagens type I and III, lysyl oxidase (LOX), biglycan, lumican and fibronectin were downregulated, while MMP3 was increased together with a decrease of its natural inhibitors (TIMP1, TIMP2 and PAI‐1). These findings were statistically corroborated for key ECM elements at the protein level (COL1, MMP1 and TGFB1). Interestingly, striae albae fibroblasts retained a pro‐inflammatory phenotype, as suggested by increased gene expression of CXCL8, HAS1 and TNFA. We next reconstructed a full thickness skin model (Striae Reconstructed) with dermal fibroblasts from striae albae. Gene expression analysis showed that the Striae Reconstructed elicited not only ECM decomposition, but also skin ageing, as indicated by the upregulation of P16, PTGS2 and SOD2. Discussion points: Although the epidermis was constructed with normal human epidermal keratinocytes, the Striae Reconstructed presented epidermal atrophy and a dramatic increase of β1‐integrin at the epidermal‐dermal junction providing, for the first time to our knowledge, a rationale showing that the key cell player behind stretch marks are dermal fibroblasts rather than epidermal keratinocytes. Conclusion: New knowledge: Taken together, our findings shed new light into the aetiology of stretch marks and indicate that the Striae Reconstructed, a new model for in vitro testing and drug screening, may open new avenues for the treatment of stretch marks. [ABSTRACT FROM AUTHOR]

Background: Striae distensae are common dermal lesions that progress through two different stages: the striae rubra, which appears to be erythematous, and striae alba, which is characterized by a hypopigmented feature. The clinical characteristics between striae distensae stages and normal skin remain unknown. Objectives: We aimed to investigate the clinical characteristics according to stages of striae distensae in terms of their biophysical properties, using objective noninvasive measurements in comparison with adjacent normal skin. Methods: Sixty‐one healthy female subjects with striae distensae were included as follows: 30 with striae rubra and 31 with striae alba on the abdomen and thighs. Hydration of the epidermis and dermis, skin color brightness, and Erythema index were measured. Skin elasticity, roughness, and dermal echo‐density of the skin with striae distensae and adjacent normal skin were also measured. Results: Hydration of the epidermis and dermis showed no significant difference between the skin with striae distensae and normal skin. Brightness of skin with striae alba and normal skin was significantly higher than that of skin with striae rubra. Erythema index of skin with striae rubra was significantly higher than that of skin with striae alba and normal skin. Skin with striae rubra and striae alba had a rougher surface than normal skin. Elasticity and dermal echo‐density were significantly lower in striae distensae skin. Conclusions: Striae rubra and striae alba had similar biophysical properties in terms of skin hydration, elasticity, roughness, and dermal density. Moreover, striae distensae have less elasticity, more roughness, and lower dermal density than normal skin. [ABSTRACT FROM AUTHOR]

Objective: To assess the effects of galvano-puncture (GG) and dermabrasion (DG) in reducing striae distensae in the gluteal region of women. Methods: This randomized, controlled, single-blind clinical trial was conducted at the UNIFAL-MG. Participants were 48 female who had striae distensae alba in the gluteal region. They were randomly divided in GG; DG; and Control Group (CG). The length and width of the largest striae were measured (in millimeters) using a caliper. The same striae were assessed before and after treatment. Infrared thermography was performed in the gluteal region to assess local microcirculation. Results: Intragroup analysis showed a significant reduction in the dimension of the striae between baseline and treatment session 10 in the GG and DG groups. Between-group analysis revealed a reduction in the width and length of the striae for both the GG and DG groups, but there were no significant differences between the two groups. When compared to the CG and the DG group, the GG group had significant improvements, as shown by thermography. Conclusion: Both GG and DG are effective in reducing striae length and width. However, only the thermography results showed significant differences between GG and control, and between GG and DG. [ABSTRACT FROM AUTHOR]

Striae distensae (SD), otherwise known as "stretchmarks," are a common presenting complaint, particularly in young healthy women. SD are hypothesized to form in a patient when the cross-linked collagen is "overstretched" and rupture of this collagen matrix causes the striae. Thus, many treatments work by increasing collagen synthesis. This review critically appraises the evidence to date for the treatment of SD, including both energy-based devices and topical treatments. [ABSTRACT FROM AUTHOR]

Summary: Background: Striae distensae are dermal scars with a linear atrophic depression. The exact origin of striae distensae remains unrevealed, but low expression of collagen and fibronectin genes in the affected tissue was found. Several treatment modalities have been proposed, yet no consistent modality is available. Aim of the work: To evaluate and compare the efficacy and safety of carboxytherapy vs platelet‐rich plasma (PRP) in treatment of stretch marks. Patients and methods: This study included 20 patients with striae alba. Every patient received treatment in the form of PRP injection in their right side (group A) and carboxytherapy session in their left side (group B) every 3‐4 weeks for 4 sessions. Skin biopsies were taken before and after treatment, and they were subjected to fibronectin immunohistochemical stain. Results: There was a significant improvement in striae alba in both groups after than before treatment. There was no significant difference between both groups as regards either percentage of improvement, response (grading scale), or patient satisfaction. The fibronectin‐stained area was significantly higher in both groups after than before treatment, and it was significantly higher after treatment in group (B) than group (A). Conclusions: Both methods were safe and effective with minimal side effects. There was no significant difference between both methods of treatments. This was confirmed histopathologically by fibronectin expression which is found to be low in striae and increased significantly after treatment. But fibronectin expression was higher in group (B) than (A). [ABSTRACT FROM AUTHOR]

Summary: Objective: The aim of the study was to evaluate the effectiveness of carboxytherapy in the treatment of striae distensae. Additionally, discomfort and side effects associated with the treatment were assessed. Materials and methods: This study involved 15 women aged 22‐40 years. They underwent 3 sessions of carboxytherapy at one‐week intervals. Treatment was performed in skin area within stretch marks located on stomach, buttocks, and thighs. Cutometric probe was used to evaluate skin elasticity. Four measurements were performed—immediately before each treatment and one month after the last session. Photographic documentation was made before and after a series of treatment to perform clinical evaluation of changes in skin condition. Results: Statistical analysis of results obtained with the use of Cutometer (R2 and R8 parameters) demonstrated that carboxytherapy significantly improved skin elasticity within stretch marks (P < .05). The analysis of photographic documentation revealed 58% improvement in stretch mark visibility. The width and length of stretch marks decreased, and their color became more like the natural color of the skin. Carboxytherapy is associated with moderate pain/discomfort. The occurrence of hematoma is the main side effect of this procedure. Conclusions: Carboxytherapy seems to be an effective method of reducing stretch marks. This procedure is safe, and it can be performed without the risk of complications. Moreover, it does not require special postoperative convalescence. Photographic documentation is a method of assessment of aesthetic procedures effectiveness, which is complementary to other objective methods (eg, the use of MPA probes). [ABSTRACT FROM AUTHOR]

Summary: Background: Striae have been reported to be one of the most common skin changes and a commonly encountered esthetic problem. Objectives: To analyze risk factors of striae not associated with pregnancy and verify if body build and composition influence striae distensae (SD) occurrence and visibility. Methods: Eighty female students (40 with striae (the mean age 23.9 years, SD 2.05 years) and 40 without these lesions (24.7 years, SD 6.2 years)) were included in the study. The subjects were asked to fill out a questionnaire including questions concerning risk factors of SD. Body build and composition were examined using Tanita SC‐331S Body Composition Analyzer. Results: Women without striae more often reported a history of intended weight loss (P <.0001), less frequently had a history of contraceptives intake (P <.001) and more often their family history of striae was negative or unknown (P =.01). Multivariate analysis including body build and composition parameters indicated BMI as risk factor of SD (P =.021; OR =1.155, 95% CI 1.006; 1.325). Conclusions: History of contraceptives intake and a family history of striae are risk factors of SD occurrence, while weight loss can reduce the risk of these lesions. BMI appeared to be the risk factor of striae visibility, especially in abdomen, but not on the buttocks. Further clinical researches are needed to examine the pathophysiology of this condition and to inform patients about the possibility to reduce the risk of striae occurrence. [ABSTRACT FROM AUTHOR]

Striae distensae (SD) are atrophic dermal scars often found on abdomen, breasts, thighs, and hips of pregnant women. The strias' self-healing without any intervention is a poor possibility. Till now, several lasers and light sources have been used for treatment of SD. However, there are no integrated therapeutic approaches determined for treatment of SD yet. So, in this study, the therapeutic effect of fractional ablative CO2 laser in women with pregnancy was assessed. Twenty-four ethic Iranian women aged between 20 and 42 years with various severity of pregnancy SD enrolled in retrospective case series study. Participants with skin types II-IV were treated in four sessions with a one-month interval by fractional ablative CO2 laser. The severity of striae was determined by Daveys scoring. Clinical improvement was assessed by comparing pretreatment and posttreatment clinical photographs based on global improvement scoring. The evaluation of clinical results showed that fractional ablative CO2 laser was an effective treatment. Twenty of 24 (83.3%) patients showed improvement. Clinical improvement was affected by striae severity (P = 0.03). Also, there were no statistical differences between clinical improvements with skin types, striae scar severity, number of pregnancy, and striae location. [ABSTRACT FROM AUTHOR]

BACKGROUND Few effective treatments exist for striae alba, which are the mature stage of stretch marks. OBJECTIVE To evaluate the efficacy of the nonablative fractional 1,565-nm Erbium-glass (Er:glass) and the picosecond fractional 1,064/532-nm neodymium:yttrium-aluminum-garnet (Nd:YAG) lasers in the treatment of striae alba. MATERIALS AND METHODS Twenty subjects with striae alba on the bilateral abdomen were treated with either the nonablative fractional 1565-nm Er:glass or the picosecond fractional 1,064/532-nm Nd:YAG laser, with a total of 3 treatments 3 weeks apart. RESULTS A 31% (1.25/4) texture improvement was noted for both the fractional 1,565-nm Er:glass laser and the picosecond fractional 1,064/532-nm Nd:YAG laser. The degree of atrophy was improved by 30% (1.19/4) with the 1,565-nm Er:glass laser and 35% (1.38/4) with the picosecond 1,064/532-nm Nd:YAG laser. A 48% (1.9/ 4) subject overall assessment of improvement was noted with the fractional 1565-nm Er:glass laser and 45% (1.8/4) improvement with the picosecond fractional 1,064/532-nm Nd:YAG laser. There was no significant change in striae density with either laser. The picosecond laser was rated as less painful during all 3 sessions (p = .002) and had a shorter healing time (p = .035). The nonablative fractional 1,565-nm Er:glass and the picosecond fractional 1,064/532-nm Nd:YAG lasers were equally efficacious in improving striae alba. [ABSTRACT FROM AUTHOR]

Objective: Centella asiatica (Pegagan) contains asiaticoside for treatment of striae patients by increasing the synthesis of collagen. Asiaticoside has a large hydrophilic molecule (959.12 g/mol), causing difficulty in penetration through the skin. Nanoemulsion has small droplet size so that the active substance can be delivered into the skin layer. This study aims to formulate and test the stability of nanoemulsion lotion containing pegagan extract. Methods: Nanoemulsion containing pegagan extract formulated in the form of lotion using High Pressure Homogenizer. Nanoemulsion lotion were then evaluated and tested for penetration in vitro. Result: The mean particle size of nanoemulsion was 19.88 ±2.3 nm and nanoemulsion in lotion was 198.4 ±11.52 nm, polydispersity index value 0.329 ±0.065, and zeta potensial was -30.9 mV. Nanoemulsion lotion was stable against storage for 8 weeks at cold, room, and high temperature (4 ±2°C, 28 ±2°C, 40 ±2°C). There were no change in physical properties and pH value of the nanoemultion lotion. The cumulative amount of the penetrated asiaticoside was 1558.65 ±66.93 μg/cm2 for nanoemulsion lotion and 1260.364 ±71.42 μg/cm2 for lotion only. Flux of nanoemulsion lotions and lotion were 2.1255 ±0.31 μg/cm2/hr and 1.4506 ±0.49 μg/cm2/hr, respectively. Conclusion: It can be concluded that nanoemulsion lotion stable in physical properties during storage and can penetrate more than the non nanoemulsion lotion. [ABSTRACT FROM AUTHOR]

Background: Striae gravidarum is a common skin problem of considerable cosmetic concern for many pregnant women. Various risk factors associated with the development of striae have been reported, with conflicting results. Objectives: To analyze the risk factors of striae gravidarum in Chinese primiparous women and to provide evidence relevant to the prevention of this condition. Methods: Singleton primiparous pregnant women who were hospitalized for delivery were included, and relevant data were collected. Independent risk factors associated with striae gravidarum in women with and those without striae gravidarum were identified using logistic regression. Results: Among 213 singleton primiparous pregnant women, 125 had striae gravidarum, yielding a prevalence of up to 58.9%. There was a significant variation (P < 0.05, odds ratio >1) between the striae gravidarum and non-striae gravidarum groups in terms of several factors, including younger maternal age, weight gain during pregnancy, body mass index gain, uterine height, abdominal girth, and positive family history. Factors such as maternal height, birth weight, systemic disease, skin type, and neonatal gender did not significantly differ between the 2 groups. Conclusion: This study showed that the independent risk factors for striae gravidarum in primiparous women were younger maternal age, weight gain during pregnancy, body mass index gain, uterine height, abdominal girth, and a positive family history. The severity of striae gravidarum was associated with weight gain during pregnancy, body mass index gain, abdominal girth, and timing of the onset of striae gravidarum. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the relationship between striae gravidarum (SG) score and abdominal scar characteristics together with intraperitoneal adhesion (IPA) grades of patients who were hospitalized for second cesarean delivery. Methods: A total of 145 consecutive women undergoing scheduled cesarean section (CS) in a tertiary level maternity hospital between November 2013 and January 2014 were included in the study. All women had transverse suprapubic skin incision due to the previous CS and none of them had a history of vaginal delivery. Patients were classified according to the SG status, as women with no SG: Group-1(n=53), mild SG: Group-2(n=27) and severe SG: Group 3(n=65). Groups were compared between themselves with regard to various sociodemographic properties, cesarean scar characteristics and IPA scores. Results: No significant difference in the length, width and color of the scar was detected among groups. While flat scar was the most prominent form of scar, the elevated scar was significantly more frequent in Group-1 compared to other groups (p=0.009). IPA grades were 0 or 1 in 77.3% of Group-1, 81.3% of Group-2 and 76% of Group-3. There was no significant difference in IPA scores between groups (p=0.884). After combining CS scar characteristics (flat, depressed and elevated) and SG status [SG (+) or SG (-)], we found no significant difference between the groups in terms of IPA severity. Conclusion: Striae gravidarum (SG) was found to be associated with scar characteristics, but not associated with the severity of intraperitoneal adhesion (IPA). [ABSTRACT FROM AUTHOR]

Summary: Background: Striae distensae (SD) are a common dermatologic problem that plagues many people. Although there are many therapeutic modalities have been used to treat SD, effective method has been disappointing for striae Alba. Aims: To evaluate the clinical and histopathologic efficacy and safety of the 2940‐nm erbium yttrium aluminum garnet (Er:YAG) ablative fractional laser (AFL) with recombinant bovine basic fibroblast growth factor (rb‐bFGF) and light‐emitting diode‐red light (LED‐RL) for the treatment of striae alba. Patients and methods: Thirty volunteers with striae distensae alba were enrolled. The subjects completed treatments with the 2940‐nm Er:YAG AFL 6 times at 4‐week intervals. Following this treatment, the subjects were required to spray rb‐BFGF for 1 week at home. They then received LED‐RL once every 7 days for three sessions between the two laser treatments. Two independent investigators evaluated clinical improvement at pretreatment and 1, 3, 6, and 12 months post‐treatment, patients also provided self‐assessments of clinical improvement. Two biopsies were obtained from two subjects, both of the same sites of striae alba, one before the first treatment and one 6 months after the last session. Results: All 30 subjects demonstrated clinical improvement after treatment. Skin biopsies after treatment showed an increase in epidermal thickness, dermal thickness, and collagen and elastin density when compared to that at the baseline. Conclusions: The combination of the 2940‐nm Er:YAG laser with rb‐bFGF and LED‐RL for the treatment of striae alba was a safe and effective approach for improving the appearance of striae alba. [ABSTRACT FROM AUTHOR]

This research work mainly deals with studying qualitatively the changes in the dermal collagen of two forms of striae distensae (SD) namely striae rubrae (SR) and striae albae (SA) when compared to normal skin (NS) using confocal Raman spectroscopy. The methodology includes an in vivo human skin study for the comparison of confocal Raman spectra of dermis region of SR, SA, and NS by supervised multivariate analysis using partial least squares discriminant analysis (PLS-DA) to determine qualitatively the changes in dermal collagen. These groups are further analyzed for the extent of hydration of dermal collagen by studying the changes in the water content bound to it. PLS-DA score plot showed good separation of the confocal Raman spectra of dermis region into SR, SA, and NS data groups. Further analysis using loading plot and S-plot indicated the participation of various components of dermal collagen in the separation of these groups. Bound water content analysis showed that the extent of hydration of collagen is more in SD when compared to NS. Based on the results obtained, this study confirms the active involvement of dermal collagen in the formation of SD. It also emphasizes the need to study quantitatively the role of these various biochemical changes in the dermal collagen responsible for the variance between SR, SA, and NS. [ABSTRACT FROM AUTHOR]

Summary: Background: Striae gravidarum (SG), or stretch marks of pregnancy, begin as erythematous streaks and mature into hypopigmented atrophic bands. Objectives: In order to investigate molecular alterations that may promote atrophy of SG, we investigated dermal type I collagen fibrils, which provide human skin with support. Methods: We obtained skin samples of recently developed, erythematous abdominal SG from pregnant women. To examine the organization of collagen fibrils, second‐harmonic generation imaging was performed using multiphoton microscopy. Immunostaining was used to determine protein expression and localization of type I procollagen, the precursor of type I collagen fibrils. Real‐time polymerase chain reaction was used to determine gene expression levels. Results: In control (hip) and stretched normal‐appearing perilesional abdominal skin, dermal collagen fibrils were organized as tightly packed, interwoven bundles. In SG, collagen bundles appeared markedly separated, especially in the mid‐to‐deep dermis. In the spaces separating these bundles, loosely packed wavy collagen fibrils lacking organization as bundles were present. These disorganized fibrils persisted into the postpartum period and failed to form densely packed bundles. Numerous large fibroblasts displaying type I procollagen expression were in close proximity to the disorganized fibrils, suggesting that the fibrils are newly synthesized. Supporting this possibility, immunostaining and gene expression of type I procollagen were increased throughout the dermis of SG. Conclusions: Early SG display marked separation of collagen bundles and emergence of disorganized collagen fibrils that fail to form bundles. These alterations may reflect ineffective repair of collagen bundles disrupted by intense skin stretching. Persistent disruption of the collagenous extracellular matrix likely promotes formation and atrophy of SG. [ABSTRACT FROM AUTHOR]

Abstract: Objective: The normal process of skin tissue repair following injury invariably results in visual scarring. It is known that topical treatment with hydrophobic cosmetics rich in silicone and mineral oil content can improve the appearance of scars and striae. Given lifestyle preferences of many cosmetic consumers towards so‐called natural treatments, the objective of this controlled randomized study was to investigate the efficacy of a plant body oil rich in oleic and linoleic acids (Bio Skin Oil®) for improving the appearance of scars and striae. Methods: A panel of 80 volunteers with non‐hypertrophic scars (40) or stretch marks (40) not older than 3 years applied a cosmetic face and body oil for 8 weeks. Compared to an untreated scar/stretch mark region, a blinded investigator as well as volunteer assessments with given observed parameters demonstrated the efficacy of the oil under test. Results: On the Observer Scar Assessment Scale (OSAS), the mean score was reduced on the product‐treated area by approximately 5% (P = 0.006). The untreated area remained unchanged. Observed effects by volunteers were more pronounced – Patient Scar Assessment Scale (PSAS) giving a reduction of approximately 20% on the treated area, and on the control untreated area a reduction of approximately 6%. The overall product effect of 14% was shown to be clearly significant (P = 0.001). All statements relating to product traits achieved higher frequencies of agreements than of non‐agreements and were therefore assessed positively by the volunteers. Highest frequencies of agreements occurred in statements that the test product provides a long‐lasting, soft and supple skin feeling (93%); caring effect (87%); and quick absorbance (84%). Agreement was also found for statements that the product improves the skin appearance (61%) and that scars/striae appear less pronounced (51%). Only 17% of volunteers felt the oil had no benefit to the appearance of their scars/striae. Conclusions: The oil blend under test is effective in improving the appearance of non‐keloid scars and striae. Further work is required to understand the mechanisms of how plant oil fatty acids ameliorate scar and striae appearance. [ABSTRACT FROM AUTHOR]

Abstract: Background: This study examines the clinical characteristics and demographics of teenage boys with horizontal striae distensae of the lower back in an outpatient setting. Methods: Retrospective medical chart reviews and telephone survey studies were completed on an outpatient cohort of 12 boys 11 to 17 years of age with a clinical diagnosis of transverse striae distensae of the lower back at a single‐center, university‐based, pediatric dermatology practice. We evaluated the clinical features of the striae, participant demographic characteristics, and past medical history. A review of the literature concerning risk factors was conducted using PubMed and Google Scholar. Results: Of the 14 patients we contacted, 12 agreed to participate. The average age of onset for the striae was 14.3 years. All boys were above the 50th percentile in height at the time of onset. Eight (66.7%) reported a significant growth spurt before the appearance of the stretch marks. Most were asymptomatic. None of the boys had a history of unmonitored exogenous steroid use or prior infection with Bartonella henselae or Borrelia burgdorferi. Only one (8.3%) had a chronic medical condition. Eleven (91.7%) had at least one first‐degree relative with striae distensae. Conclusion: Our results indicate that horizontal striae distensae of the lower back in adolescent boys is associated with a rapid growth spurt, tall stature, and family history of striae distensae. There is no association between this type of striae distensae and any chronic medical condition, bacterial infection, or exogenous steroid use. Thus a careful review of systems and counseling without further medical testing is reasonable management. [ABSTRACT FROM AUTHOR]

Background: Needleless transcutaneous pneumatic injections (TPIs) are a minimally invasive way to deliver the solution into the skin for therapeutic purposes. The suggested action mechanisms of TPI therapy include mechanical stimulation, immediate tissue shrinkage and late wound healing. Methods: Thirteen Korean patients were treated with TPI for atrophic skin disorders, including acne scars, striae albae, post-furuncle, or carbuncle scars, and horizontal wrinkles with lipoatrophy. At each TPI treatment session, a single pass was made along with the atrophic skin lesions without overlapping. Thereafter, two dermatologists objectively evaluated the clinical improvement in the lesions in the photographs via the global aesthetic improvement scale (GAIS). Results: One month after the final treatment, the overall mean GAIS score was 2.3 ± 0.8. Six of the 13 (46.2%) patients exhibited clinical improvement of grade 3, five (38.5%) patients grade 2 and two (15.4%) patients grade 1. The overall mean subjective satisfaction score with the TPI treatment was 2.3 ± 0.9. Six of the 13 (46.2%) patients achieved subjective satisfaction of grade 3, six (46.2%) patients grade 2 and one (7.7%) patient grade 0. Conclusions: The present study demonstrated that the TPI treatment is effective and safe for treating atrophic skin disorders of varying causes in Korean patients. [ABSTRACT FROM AUTHOR]

Objective Striae gravidarum is a form of scarring on the skin observed during pregnancy and can cause serious cosmetic problems. Striae gravidarum may be influenced by hormonal changes, although the etiology is not clear. The aim of this study was to investigate whether body mass index ( BMI) and serum collagenase-2 levels in pregnant women are related to the development of striae gravidarum. Methods Thirty pregnant women with striae, 30 pregnant women without striae, and 32 health controls were enrolled in the study. Results BMI and serum collagenase-2 levels were measured in the participants. Conclusion Pregnant women with striae gravidarum had increased serum collagenase-2 and BMI levels when compared to pregnant women without striae gravidarum and healthy controls ( P < 0.05). The increase in serum collagenase-2 levels was related to the development of striae gravidarum alone, or secondary to BMI increase. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the incidence of postoperative posterior capsular striae (PCS) and its influence on posterior capsular opacification (PCO) in patients implanted with two types of lens material.Setting: Tertiary eye care center in central rural India.Study Design: A prospective, observational, nonrandomized study.Materials and Methods: The study included 1247 patients having age-related cataract scheduled for removal by phacoemulsification technique and implantation of hydrophilic or hydrophobic intraocular lens (IOL). Demographic profile, nuclear grading, axial length, and IOL power were noted. Details of PCS were noted on the 1st postoperative day in patients with clear cornea. Postoperative follow-up was ensured to study the status of PCS and development of PCO.Results: The overall incidence of PCS was 19.8% (247 out of 1247 eyes). Out of 1247 patients, 641 patients (51.4%) had hydrophilic IOL implantation and 201 eyes had PCS (31.4%) and 606 patients (48.6%) had hydrophobic IOL implantation and 46 eyes had PCS (7.6%), P = 0.04. Three and more striae were seen in 119 eyes (119/641, 18.6%) in hydrophilic group and 4 eyes (4/606, 0.66%) in hydrophobic group. Sixty-two eyes (62/201, 30.9%) in hydrophilic group with multiple PCS were reported with persistent striae after 6 months of surgery. Two eyes in hydrophobic group had persistent striae even after 3 years of follow-up. Evaluation of PCO score of the hydrophilic group was 0.6 whereas of the hydrophobic group was 0.1 (P = 0.04). Ten patients of the hydrophilic group only required neodymium-doped yttrium aluminum garnet (ND: YAG) laser capsulotomy.Conclusion: The incidence of PCS was higher in hydrophilic than hydrophobic IOLs. Multiple PCS persisting in patients beyond 6 months after operation should be followed up for early development of PCO, particularly in patients implanted with hydrophilic IOL. [ABSTRACT FROM AUTHOR]

BACKGROUND Striae distensae (SD) are aesthetically troublesome to patients and therapeutically challenging. OBJECTIVE Herein, the authors comprehensively review the literature pertaining to the history, pathogenesis, clinical presentation, clinical rating scales, and laboratory, imaging, and histologic features of SD. METHODS AND MATERIALS A review of PubMed, MEDLINE, Scopus, Embase, and Google scholar was conducted, including literature published from 1773 to August 6, 2016. RESULTS The authors identified 68 articles that met inclusion and exclusion criteria. CONCLUSION There are few randomized controlled trials evaluating the long-term efficacy and safety of various topical and energy-based devices. Based on clinical and anecdotal experience, both nonablative and ablative fractionated lasers have shown modest SD improvement compared with other treatment modalities (including Excimer laser, CuBr laser, pulsed dye laser, and 1,064-nm Nd:YAG laser). In the authors' experience, 1,540-nm nonablative fractionated laser is a worthy first-line modality for the treatment of SD. Future researchers may consider greater focus on enhanced study design, including larger, long-term split-body, or split-SD head-to-head randomized comparative trials with objective outcome measures and end points, such as biopsy and molecular studies demonstrating increased collagen and elastic fibers that correlate to clinical improvement. [ABSTRACT FROM AUTHOR]

Striae distensae (SD) is a challenging cosmetic problem for which various treatment modalities have been applied. Our aim was to evaluate the efficacy and tolerability of needling therapy versus microdermabrasion with sonophoresis in the treatment of SD.Materials and methods:Forty female patients with SD (mean duration 2.98 ± 2.66) were enrolled in this study. Patients were assigned to two groups, Group 1 treated with needling therapy and Group 2 treated by microdermabrasion with sonophoresis. In Group 1, three sessions of needling therapy were performed for each patient with 4-week interval between the sessions, while in Group 2, ten sessions of combined microdermabrasion and sonophoresis were performed for each patient. Skin biopsies were taken from the most atrophic site stained with hematoxylin and eosin stain and Masson trichrome stains to study the histopathological changes and efficacy of treatment, respectively.Results:There was a significant clinical improvement in SD in Group 1 compared with Group 2. Amount of collagen, number of fibroblasts, and epidermal thickness increased in the dermis at the end of treatment sessions (90% in Group 1 compared to 50% in Group 2).Conclusion:Needling therapy is an easy, safe, and economic method and considered as a suitable modality in management of striae. [ABSTRACT FROM PUBLISHER]

Striae distensae, commonly known as stretch marks, are benign skin lesions associated with considerable cosmetic morbidity. Despite considerable investigations into their origins, the pathogenesis of striae distensae remains unknown. Currently, there is no treatment which consistently improves the appearance of striae. With a high incidence and unsatisfactory treatments, stretch marks remain an important target of research for an optimum consensus of treatment. The aim of present article is to appraise the readers with various newer treatment options in the management of this difficult condition. [ABSTRACT FROM AUTHOR]

The bed nucleus of the stria terminalis (BNST) plays a critical role in fear and anxiety. The BNST is important for contextual fear learning, but the mechanisms regulating this function remain unclear. One candidate mechanism is corticotropin-releasing-factor (CRF) acting at CRF type 1 receptors (CRFr1s). Yet, there has been little progress in elucidating if CRFr1s in the BNST are involved in different types of fear (conditioned and/or unconditioned). Therefore, the present study investigated the effect of antalarmin, a potent CRFr1 receptor antagonist, injected intracerebroventricularly (ICV) and into the dorsolateral BNST ( L BNST) during single trial contextual fear conditioning or exposure to the predator odor 2,5-dihydro-2,4,5-trimethylthiazoline (TMT). Neither ICV nor L BNST antalarmin disrupted unconditioned freezing to TMT. In contrast, ICV and L BNST antalarmin disrupted the retention of contextual fear when tested 24 h later. Neither ICV nor L BNST antalarmin affected baseline or post-shock freezing—indicating antalarmin does not interfere with the early phases of contextual fear acquisition. Antalarmin did not (1) permanently affect the ability to learn and express contextual fear, (2) change responsivity to footshocks, or (3) affect the ability to freeze. Our findings highlight an important role for CRFr1s within the L BNST during contextually conditioned fear, but not unconditioned predator odor fear. [ABSTRACT FROM AUTHOR]

Wound healing is an incredibly complex biological process that often results in thickened collagen-enriched healed tissue called scar. Cutaneous scars lack many functional structures of the skin such as hair follicles, sweat glands, and papillae. The absence of these structures contributes to a number of the long-term morbidities of wound healing, including loss of function for tissues, increased risk of re-injury, and aesthetic complications. Scar formation is a pervasive factor in our daily lives; however, in the case of serious traumatic injury, scars can create long-lasting complications due to contraction and poor tissue remodeling. Within this report we target the expression of connective tissue growth factor (CTGF), a key mediator of TGFβ pro-fibrotic response in cutaneous wound healing, with controlled local delivery of RNA interference. Through this work we describe both a thorough in vitro analysis of nanolayer coated sutures for the controlled delivery of siRNA and its application to improve scar outcomes in a third-degree burn induced scar model in rats. We demonstrate that the knockdown of CTGF significantly altered the local expression of αSMA, TIMP1, and Col1a1, which are known to play roles in scar formation. The knockdown of CTGF within the healing burn wounds resulted in improved tissue remodeling, reduced scar contraction, and the regeneration of papillary structures within the healing tissue. This work adds support to a number of previous reports that indicate CTGF as a potential therapeutic target for fibrosis. Additionally, we believe that the controlled local delivery of siRNA from ultrathin polymer coatings described within this work is a promising approach in RNA interference that could be applied in developing improved cancer therapies, regenerative medicine, and fundamental scientific research. [ABSTRACT FROM AUTHOR]

Background: Striae are acommonchange during pregnancy, leaving striae in various body parts after delivery, which mostwomen find unpleasant. They create a big aesthetic concern for most women. Although striae do not endanger the mother and the fetus, theymaycause a desire to scratch the region leading to small wounds, induce stress over beauty, decrease self-confidence, and create psychological disorders. They may try various treatments and often refer to dermatology clinics and receive long-term treatments; these time-consuming and costly behaviors and may affect their quality of life. Objectives: The aim of this study was to evaluate the quality of life in Iranian postpartum women with and without striae gravidarum. Materials and Methods: This cross-sectional study was conducted on 145 women who had referred to health centers of Mashhad to receive post-delivery health care six weeks after delivery during year 2013. Multi-stage sampling was applied to select the participants. The tools used were demographic, SF-36 quality of life, Skindex29, Atwal and Fitzpatrick classification questionnaires. Data were analyzed using the SPSS V.11.5 software. Results: The subjects' mean age was 26.3 ± 5.7. Mann-Whitney test showed there was a significant difference between mean of Skindex29 and its dimensions (P < 0.001), general life quality (P < 0.001) in women with and without striae. Mann-Whitney test showed no significant difference between mean general quality of life dimension, except physical function in women with and without striae (P > 0.05). Conclusions: The results showed that striae lead to reduced quality of general life and reduced skin quality index in women postpartum. [ABSTRACT FROM AUTHOR]

This article utilizes notions of ‘agency’ to explore the relationship between experiences of pregnancy loss and narratives about related skin-based body modifications. The term ‘pregnancy loss’ is used to denote a range of medical events with potentially far-reaching emotional and social consequences. The research from which the empirical content of this article is drawn seeks to bring together feminist interests and the discipline of human geography to examine experiences of pregnancy loss. Different aspects regarding ‘agency’ are attended to through several practices—namely, the acquisition, display/concealment and narration of skin-based bodily marks like stretch marks and memorial tattoos. This includes a discussion on notions of ‘choice’ in terms of receiving/acquiring changes to the skin through pregnancy and pregnancy loss, regarding which stretch marks and tattoos are often pitted as oppositional. A more complex picture of agency is explored and illustrated with the narratives of several women with pregnancy-loss experiences, highlighting that both kinds of skin-based modifications can be framed in more agential ways, including as appreciated reminders of simultaneous love and loss. In doing so, this article constitutes an attempt to engage with pregnancy loss from a feminist perspective, as encouraged by Linda Layne, and to contribute to feminist scholarship on body modifications. [ABSTRACT FROM PUBLISHER]

Background and objectives:Striae are atrophic dermal scars with overlying epidermal atrophy causing cosmetic concern. This study assesses and compares the efficacy and safety of needling therapy versus CO2 fractional laser in treatment of striae.Methods:Twenty Egyptian female patients with striae in the abdomen and lower limbs were involved in the study. The patients were treated with needling therapy and CO2laser every 1 month for 3 sessions. Follow-up by digital photography and skin biopsy was conducted at baseline and 6 months after treatment. Clinical improvement was assessed by comparing photographs and patient's satisfaction before and after treatment.Results:Nine of 10 (90%) needle-treated patients showed improvement. Among them, 3 (30%) had good, 4 (40%) had fair, and 2 (20%) had poor improvements; however, 1 (10%) did not show any improvement after the treatment. In CO2-laser treated patients, 5 of 10 (50%) of the patients showed clinical improvement; 1 (10%) were good, 3 (30%) were fair, and 1 (10%) were poor; however, 5 (50%) did not show improvement.Conclusion:The results support the use of microneedle therapy over CO2lasers for striae treatment. [ABSTRACT FROM AUTHOR]

It has been shown that the bed nucleus of the stria terminalis (BNST) of rats contains nitrergic neurons, which are activated during animal exposure to aversive stimuli. The BNST is also populated by glutamatergic and corticotrophin releasing factor (CRFergic) neurons, which in turn are activated under stressful situations. Here we investigated the anxiogenic-like effects of intra-BNST injections of a nitric oxide (NO) donor, NOC-9 in mice. The role of CRFergic and glutamatergic systems on defensive behavior induced by NOC-9 was investigated with previous intra-BNST infusion of different doses of CP376395, a CRF type 1 receptor antagonist (CRF1), or AP-7, an NMDA (N-methyl- d -aspartate) receptor antagonist. Anxiety-like behavior was assessed immediately and 5 min after intra-BNST drug injection, exposing mice to a novel arena and to the elevated plus-maze (EPM; an anxiogenic situation). Results showed that NOC-9 provoked a short period (≈ 150 s) of freezing behavior in the novel arena and increased anxiety in the EPM. Both CP and AP-7 attenuated the anxiogenic-like effects of NOC-9 in the EPM without changing freezing behavior in the novel arena. When given alone (i.e. without prior intra-BNST injection of NOC-9), AP-7 (0.20 nmol), but not CP (0.75, 1.50, or 3.00 nmol), attenuated anxiety in mice exposed to the EPM. These results suggest that CRF1 and NMDA receptors located within the BNST differentially modulate aversive effects induced by NO production in this limbic forebrain structure. [ABSTRACT FROM AUTHOR]

Introduction: Striae are the most frequently occurring pathology of connective tissue during pregnancy. According to the statistical data, 70-90% of women suffer from striae gravidarum. Aim: To assess effectiveness of topical products and massage used by pregnant women in striae gravidarum prophylaxis. Material and methods: The questionnaire study was conducted among 299 women who were maximum 6 months after delivery at term. The questionnaire included questions concerning age, occurrence of striae gravidarum during pregnancy, their location, week of gestation when the lesions appeared and used striae prophylaxis as well as its effectiveness in respondents' opinion. Results: Analysis of the correlation between striae gravidarum occurrence and use of different types of cosmetics showed that this kind of prophylaxis is effective when applied at least twice a day (63.7% vs. 77.6%). No correlation between the type of cosmetics and presence of striae was observed (p > 0.05). Conclusions: Use of prophylactic measures like skin emollients and oils with the appropriate frequency significantly reduces the risk of striae gravidarum occurrence. [ABSTRACT FROM AUTHOR]

Background Striae gravidarum ( SG), or 'stretch marks' of pregnancy, begin as erythematous streaks, and mature over months to years to become permanent scar-like bands that may be hypopigmented, atrophic and lax. Objectives To investigate early molecular alterations that may promote laxity of mature SG, we investigated the dermal elastic fibre network, which provides human skin with elastic properties. Methods We obtained skin samples of newly developed, erythematous abdominal SG in healthy pregnant women. The elastic fibre network was examined by Verhoeff elastic staining and immunofluorescence staining of skin sections. Gene expression was measured by real-time polymerase chain reaction. Results The normal elastic fibre network appeared markedly disrupted in SG, compared with perilesional abdominal skin or control (normal-appearing hip skin). This disruption was accompanied by the emergence of short, disorganized, thin, thread-like 'fibrils', which were observed prominently in the mid-to-deep dermis. These fibrils were rich in tropoelastin (the main component of normal elastic fibres), and persisted into the postpartum period without forming normal-appearing elastic fibres. The emergence of these fibrils was accompanied by increased gene expression of tropoelastin and fibrillin-1, but not other elastic fibre components, including fibrillin-2 and fibulin-1, -2 or -5. Conclusions In early SG, the elastic fibre network appears markedly disrupted, and newly synthesized tropoelastin-rich fibrils emerge, likely as a result of uncoordinated synthesis of elastic fibre components. Because they are thin and disorganized, tropoelastin-rich fibrils likely do not function as normal elastic fibres do. These observations provide the foundations for elucidating pathogenic mechanisms by which laxity may develop in SG. [ABSTRACT FROM AUTHOR]

During a survey of the diatom flora of some caves on Île de la Possession, the main island of the Crozet archipelago, a small, unusual naviculoid taxon was observed, initially identified as Fallacia lenzii. The new taxon is described as Fallacia emmae but it shows features of two related genera: Fallacia and Germainiella. Thorough morphological research revealed details that, on the one hand, contradicted its placement in Fallacia, such as the relatively low number of poroids on the conopeum, the absence of external canal apertures beside the raphe slit ( Fallacia-feature), and striae that are composed of one slit-like areola ( Germainiella-feature). The morphology and taxonomy of the new taxon are discussed and questions are raised about the validity of genera recently split off from the genus Navicula on the basis of one, or occasionally two, morphological features. [ABSTRACT FROM AUTHOR]

Background Striae Distensae ( SD) or stretch marks are manifestations of epidermal atrophy that occurs after tissue tearing due to rapid growth or over-stretching and are characterized by distinct microstructural features. The objective of this in vivo study was to investigate the biophysical properties of SD lesions, including skin barrier function, skin surface hydration, mechanical properties, and chromophore concentrations, compared to normal adjacent skin. Methods Non-invasive methods were used on 29 volunteers with SD to characterize: (i) visual appearance (visual assessment and clinical imaging), (ii) skin barrier function by measuring transepidermal water loss, (iii) skin surface hydration using corneometry (skin capacitance), (iv) mechanical properties measuring skin elasticity under vacuum and surface propagation of a sonic wave, (v) the presence of erythema and pigmentation using diffuse reflectance spectroscopy, and (vi) the levels of interleukin-1α on the skin surface. Results No difference was observed in skin barrier function and a slight difference in skin hydration between the striae and adjacent uninvolved skin. Viscoelasticity measurements showed that SD lesions were significantly less firm, less elastic, and less deformable than normal skin ( P < 0.05). Mechanical anisotropy was increased in SD compared to normal skin, reflecting the skin surface anisotropy reported previously. Diffuse reflectance spectroscopy showed no differences in the apparent hemoglobin concentrations between SD and control. Skin pigmentation and light scattering values were significantly lower in SD ( P < 0.001) compared to adjacent skin and there was no correlation between them indicating independent causes: lower melanin production for pigmentation and altered collagen fiber structure in the dermis for light scattering. Conclusions Based on these results, the distinct microstructural features characterizing SD lesions are accompanied by changes in the mechanical and optical properties. These changes however do not seem to affect the skin barrier and moisturization properties. [ABSTRACT FROM AUTHOR]

Synopsis Background Stretch marks are a common skin disorder. Pregnancy-related lesions are defined as striae gravidarum. The root cause of striae formation remains unknown. Objective The aim of this paper was to identify the risk factors associated with striae gravidarum ( SG) development. Patients and methods The study was conducted at Plastic, Reconstructive and Aesthetic Surgery Clinic and Obstetrics Outpatient Department among 299 Caucasian women maximum 6 months after the delivery, regardless of whether they were primiparas or multiparas. Results Among the women participating in the study, 71.2% (213 of 299) developed striae gravidarum at least in one site. Logistic regression analysis showed that four of the analysed factors were independent predictors of striae gravidarum occurrence: family history of SG, BMI before pregnancy, the lack of chronic diseases and birthweight ( P < 0.0001). It has been found that the presence of striae distensae on the breasts increases the risk of SG development (71.4% vs. 28.6%, P = 0.0008), whereas the presence of these lesions on the thighs decreases the risk (23% vs. 77%, P = 0.0076). Conclusion In this study, we presented a model that can help to predict the risk of SG formation, including family history of SG, BMI before pregnancy, birthweight and chronic diseases. Moreover, women with stretch marks on their breasts should know that the risk of SG development is significantly higher, whereas lesions on the thighs do not increase such a risk. [ABSTRACT FROM AUTHOR]

Due to historical legal challenges, there is a driving force for the development of objective methods of forensic toolmark identification. This study utilizes an algorithm to separate matching and nonmatching shear cut toolmarks created using fifty sequentially manufactured pliers. Unlike previously analyzed striated screwdriver marks, shear cut marks contain discontinuous groups of striations, posing a more difficult test of algorithm applicability. The algorithm compares correlation between optical 3D toolmark topography data, producing a Wilcoxon rank sum test statistic. Relative magnitude of this metric separates the matching and nonmatching toolmarks. Results show a high degree of statistical separation between matching and nonmatching distributions. Further separation is achieved with optimized input parameters and implementation of a 'leash' preventing a previous source of outliers-however complete statistical separation was not achieved. This paper represents further development of objective methods of toolmark identification and further validation of the assumption that toolmarks are identifiably unique. [ABSTRACT FROM AUTHOR]

Several abstracts of articles published in the March 2015 issue are presented including the identification of hypochromic vitiligo, the prevention of striae gravidarum (SG) during pregnancy, and the identification of cluster of pemphigus vulgaris with autoimmune thyroid disease, rheumatoid arthritis and type I diabetes.

Striae gravidarum ( SG), or stretch marks developing during pregnancy, affect up to 90% of women. While not medically dangerous, SG can be disfiguring, causing emotional and psychological distress. However, studies specifically addressing the prevention of SG, especially during pregnancy, are sparse. Furthermore, the molecular pathogenesis of SG is unclear and may differ from that of striae from other causes. Considering these factors, we review topical modalities that have been used specifically for preventing SG during pregnancy. We identify two major strategies (end points) addressed by these modalities, namely (i) preventing the de novo development of SG and (ii) reducing the severity of SG that have recently developed. We also identify risk factors for the development of SG and suggest that pregnant women with these risk factors are an appropriate target population for prevention. In reviewing the literature, we find that there is limited evidence that centella, and possibly massage with bitter almond oil, may prevent SG and/or reduce their severity. There is weak evidence that hyaluronic acid prevents SG. Tretinoin holds promise for reducing the severity of new-onset SG, but its use is limited by its pregnancy category. Finally, cocoa butter and olive oil are not effective for preventing SG or reducing the severity of lesions. We conclude that reliable methods for preventing SG are scarce. Furthermore, available topical modalities generally lack strong evidence from rigorous, well-designed, randomized controlled trials with ample numbers of subjects. Thus, further research is necessary to elucidate SG pathogenesis, which may lead to effective prevention modalities. [ABSTRACT FROM AUTHOR]

Objective: Previous abdominal operations might cause severe intraperitoneal adhesions (IPA), which can complicate caesarean section (CS) procedures. When selecting the mode and timing of delivery, obstetricians are also curious about uterine scar healing if the previous operation was a CS. Uterine scar thickness is an indicator of uterine scar healing. We aimed to evaluate the possible predictive value of striae gravidarum (SG) on IPA formation and uterine scar thickness (UST). Methods: Fifty-five women with a previous CS history were evaluated for SG Davey Score. They were investigated for IPAs and lower segment uterine scar thickness during the current CS operation. Results: Out of the patients with no SG ( n = 11), mild SG ( n = 10) and severe SG ( n = 34), 1 (9.1%), 3 (30%) and 17 (50%) had IPA, respectively ( p = 0.044). The mean uterine scar thicknesses in the no SG, mild SG and severe SG groups were 3.82 ± 4.04, 5.20 ± 4.13 and 5.18 ± 3.52, respectively ( p = 0.561). Conclusions: To the best of our knowledge, this was the first study to investigate the relationship between SG and IPA and uterine scar thickness. The SG status of a patient with a previous delivery and abdominal operation history might help predict IPA status before planning a new operation. [ABSTRACT FROM AUTHOR]

Objective To investigate the relationship between two connective tissue pathologies: striae and pelvic organ prolapse (POP). Study design Four hundred and eighty-eight women who had undergone gynaecological surgery were divided into two groups. The study group ( n = 244) consisted of symptomatic patients with POP, and the control group ( n = 244) consisted of cases who underwent surgery for benign gynaecological conditions without evidence of POP. The groups were compared in terms of the presence, intensity and severity of striae, as well as their general characteristics. Results The presence of striae ( p = 0.001), number of striae ( p = 0.001) and Davey score ( p = 0.00001) were significantly higher in the study group, and the absence of striae was more common in the control group ( p = 0.00001). According to multivariate analysis, the presence of striae, an increased number of striae (>15) and a Davey score >2 increased the risk of POP 1.29 fold ( p = 0.03, 95% confidence interval [CI] 1.14–1.35), 1.19 fold ( p = 0.04, 95% CI 1.14–1.25) and 2.51 fold ( p = 0.01, 95% CI 1.66–3.78), respectively. Conclusion Striae may serve as a promising marker for POP. In particular, women who develop striae should be cautious about their risk for developing POP in the future, and should be informed about preventive methods for POP. [ABSTRACT FROM AUTHOR]

Stretch marks are common skin disorders that are dermal scars with associated epidermal atrophy. They are of significant concern or psychological concern to many. This manuscript describes the use of multipolar radiofrequency with pulsed magnetic fields that was successfully used to diminish these lesions in 16 subjects undergoing a series of treatments. The improvements noted were statistically significant and no serious adverse events were noted. [ABSTRACT FROM AUTHOR]

We describe a 32-year-old pregnant woman who was referred to our clinic after 6 weeks of observation elsewhere with a rapidly expanding orbital mass, proptosed globe and slowly decreasing of vision in her left eye. To our examination the patient presented with congested optic disc fine macular striae and some slight choroidal elevation without any retinal pigmentation. An MRI scan without contrast was performed, suggesting the signal charactheristics of an orbital mass consistent with a cellular lesion such as a cavernous hemangioma or a solitary fibrous tumour. Despite the benign-looking imaging, the fast-growing pattern of the lesion suggested a more sinister picture. A fine needle aspiration of the orbital mass was carried out, revealing the presence of an amelanotic melanoma. This case highlights the importance of considering the presence of a melanoma when there is a clear history of a rapid lesion progression. [ABSTRACT FROM AUTHOR]

Behçet's disease (BD) is a chronic systemic inflammatory disorder of unknown etiology with variable clinical manifestations. HLA-B51 allele is the most strongly associated known genetic factor. The mucocutaneous lesions (oral aphthae, genital aphthae, skin lesions such as pseudofolliculitis) constitute the hallmark of the disease, but also gastrointestinal, vascular, central nervous systems, and others may be involved. We report a case of a young man affected with Behçet's disease who presented facial telangiectasias and striae rubra in the inner region of his arms and at the level of his hips, as uncommon minor superficial vascular manifestations of BD. To manage them we have subjected the patient to a cycle of Intense Pulsed Light (IPL) therapy. Our findings showed that the use of IPL is a safe and effective treatment for telangiectasias and striae rubra, also in the complex clinical condition of Behçet's disease. In fact, the treatments were well tolerated, no sign of scarring or hyper/hypopigmentation was reported and we obtained a significant improvement of the lesions in terms of color and size of them. [ABSTRACT FROM AUTHOR]

Background: The significant increase in the popularity of breast augmentation surgeries has led to an increase in the number and types of complications; among these is the postoperative occurrence of Striae Distensae (SD). The objective of this study was to investigate the incidence of SD and describing its occurrence in association with age, breast implant volume, history of SD, history of pregnancies and breastfeeding, body mass index (BMI), changes in postoperative weight, smoking habits, and use of oral contraceptives. Methods: A cohort study was conducted and the patient data from a specific social group that underwent augmentation mammaplasty with silicone breast implants in a private clinic was analyzed. Results: 563 patients entered the cohort, while 538 completed the study. The SD incidence was 7.06%. The risk was almost the double at 22–28 years of age and triple in women of 21 years of age or less. The women who did not use oral contraceptives were 2.59 times more likely of developing SD. A higher incidence of SD was observed among those with normal or low BMI values, smokers, and in those who had implants larger than 300 ml. Conclusions: Young age, larger implant volumes, smoking, and normal or low BMI values were the risk factors responsible for the development of SD; while using oral contraceptives was found to be a protective factor. [ABSTRACT FROM AUTHOR]

Striae distensae are an extremely common, therapeutically challenging form of dermal scarring. Risk factors have been reported but much remains to be understood about their epidemiology, diagnosis and treatment. Up-to-date knowledge of the scientific research and the evidence behind both preventative and therapeutic agents are vital in order to understand striae and to offer patients the best therapeutic alternatives. We present a clinical review of the current literature concerning striae distensae and their prevention and treatment. A systematic review of the literature was undertaken using Medline, Embase and Google Scholar. Articles in English, Spanish, Portuguese, Turkish and French were included. Striae distensae occur in pregnancy, puberty and obesity as well as in numerous medical conditions and following therapeutic interventions. Proposed aetiological mechanisms relate to hormones, physical stretch and structural alterations to the integument. Assessment methods include subjective visual scoring and various imaging modalities. Treatments that we have evaluated include topical agents, used prophylactically or therapeutically, as well as light and laser therapies, which have shown improvements in the appearance of striae. Few high level evidence based medicine randomized controlled trials evaluating treatments for striae distensae exist. Topical therapeutic agents appear to lack efficacy in the prevention of striae distensae. [ABSTRACT FROM AUTHOR]

Background Stretch marks or striae distensae (SD) are characterized by epidermal atrophy following repeated over-stretching of the skin tissue. The objective of this study was to investigate the skin texture and microstructure of SD lesions compared to those of normal adjacent skin in vivo using non-invasive methods. Methods A population of 26 women and 3 men with SD were examined after giving written informed consent. Following clinical grading, skin replicas were collected, confocal microscopy was performed on SD lesions and healthy neighboring skin. Skin surface texture parameters were calculated using 3D image analysis of the skin replicas and epidermal and dermal microstructure were evaluated by analysis of the confocal images. In a parallel study, histological analysis was performed on 6 skin biopsies taken from abdominal reduction surgeries in areas where skin exhibited SD. Results Analysis of the skin surface texture showed that the SD area was more anisotropic and with higher skin roughness than the adjacent skin in terms of directions of skin microglyphics. Confocal microscopy demonstrated that SD were characterized by shallower dermal papillae ( P < 0.05) and that dermal papillae height inversely correlated to the intensity of collagen alignment on the SD sites ( P < 0.05). The histology findings confirmed the in vivo confocal microscopy findings. Conclusions The skin structure of SD is qualitatively and quantitatively different compared to healthy skin. Altered skin relief reflects structural modifications in the dermis. Flattening of the dermal-epidermal junction maybe functionally related to the observed collagen fiber alignment. Observations by non-invasive methods were in line with the histological findings and therefore relevant in studies assessing the efficacy of SD treatment options. [ABSTRACT FROM AUTHOR]

Cesarean scar defects (CSDs) that can be visualized using transvaginal ultrasonography (TVUS) may cause prolonged menstruation, irregular genital bleeding, and secondary infertility; surgical repair is sometimes necessary. We present a case of CSD, with dehiscence of the uterine incision, which was managed using wound lavage. A 38-year-old woman (gravida 4, para 4) had delivered her third and fourth children by cesarean section. Upon the resumption of menstruation, 9 months after her second cesarean section, she demonstrated prolonged menstruation and the presence of a menstrual fistula due to dehiscence of the cesarean section incision from the myometrium to the serosa. We treated the defect by lavaging with a physiological saline solution. After lavaging the wound 3 times, spontaneous healing of the dehiscent muscle layer was successfully achieved. The treatment was complication-free and the healing of the muscle layer has been maintained for more than 8 months. [ABSTRACT FROM AUTHOR]