(Striae et maculae atrophicae)
This condition may be idiopathic or symptomatic. The latter type is much the more common and may occur from a traumatism, such as the lash of a whip, capable of injuring the elastic tissues beneath the intact epidermis; it may come from the distention of the skin by ascites, anasarca, pregnancy (lineae albicantes), tumors, excessive deposits of fat, etc.; or it may be a sequel of syphilis, lepra and other diseases of the skin. The lesions occur in spots or lines and are smooth, glistering, scar-like, thin, and depressed or grooved with a peculiar mother-of-pearl appearance. If in the form of lines, they may be from one to two inches in length, from an eighth or a quarter of an inch in width and usually run parallel in an oblique direction following the natural lines of the skin. They are usually seen on the distended parts or on the hips, thighs and buttocks of adults, chiefly women. Macules or spots are more rare and vary from a pin-head to a finger-nail in size and are isolated, round or oval. In a general way they resemble a vaccine cicatrix and often a pigmented area will surround the atrophic patch. The idiopathic forms are rare, chiefly occurring as large brown macules which, after a varying duration, becomes atrophied. All the lesions lack subjective sensations though they may be anesthetic.
Etiology and pathology. – Etiological factors are obvious in the symptomatic types but the idiopathic form can only be explained as trophoneurotic, with malnutrition and circulatory disturbances as predisposing factors.
Diagnosis – This condition should be carefully distinguished from the atrophic lesions left by such diseases as tuberculosis cutis, syphilis and scleroderma.
Prognosis and Treatment. – These lesions are not removed or influenced by treatment, for once established they are permanent. Prophylaxis and other therapeutic measures are outlined under senile atrophy.