Ulceration of Abdominal Striae Distensae (Stretch Marks) in a Cancer Patient —Quiz Case

Dosal, Jacquelyn; Handler, Marc Z.; Ricotti, Carlos; Vega, Janelle; Tosti, Antonella; Kerdel, Francisco A.

doi:10.1001/archderm.148.3.385-c

Cited by 9 publications

(5 citation statements)

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“…previously observed that HU is able to inhibit vessel assembly, a crucial angiogenic process, both in vitro and in vivo, and suggest that some of the therapeutic as well as adverse effects of HU may occur through vascular mechanisms 9 . In previous cases of bevacizumab‐induced ulcerations in SD, the lesions usually improved or even resolved after the discontinuation of bevacizumab 4–8 . Hence, one may speculate that the extremely severe course of skin necroses and ulcerations observed in the present case may be due to the combination of bevacizumab and HU – both drugs known to affect angiogenic processes 1,9 …”

Section: Figuresupporting

confidence: 51%

“…The action mechanism of bevacizumab against tumor growth includes the inhibition of the formation of new vessel, regression of newly formed vasculature, altering vascular function and tumor blood flow 3 . Spontaneous ulcerations in corticosteroid‐induced SD under bevacizumab treatment have rarely been reported in the medical literature 4–8 . Indeed, HU co‐medication might have contributed to the recalcitrant and rapidly progressive necroses and ulcerations in the present patient.…”

Section: Figurementioning

confidence: 82%

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Severe ulcerations in corticosteroid‐induced striae distensae rubrae under anti‐vascular endothelial growth factor treatment of anaplastic astrocytoma

et al. 2020

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the results show a severely decreased quality of life. This is particularly relevant as physicians' judgment of disease severity has been shown to, albeit inconsistently, correlate with patient-reported scores. Health-related quality of life, rather than clinical severity of disease, was an independent predictor of work productivity. In psoriasis, indirect cost of loss of productivity has been shown to clearly exceed the total direct cost; thus, savings from work productivity might counterbalance the high cost of treatment (biologics in psoriasis, and botulinum toxins in hyperhidrosis). 5 When deciding to use the Skindex-16 instrument, we looked at what have been called weaknesses in DLQI, with its focus on function in daily activities. We found a correlation between the Skindex-16 functioning score and the DLQI score, a finding that supports the statements on the DLQI being more occupied with daily activities while Skindex-16 also measures emotions. The low percentage scores in the physical domain might be explained by the fact that Skindex-16 is not sensitive in that domain, used in hyperhidrosis. The question on perseverance, which is included, is relevant. In conclusion, quality of life in hyperhidrosis is even worse than in other major skin disease. Both instruments performed well overall. Skindex-16 had weaknesses in the physical domain and had its strength in emotions and functioning. DLQI performed strongly in functioning and correlated significantly with Skindex-16 in this domain. As DLQI is weak on emotions, we suggest using the instruments concurrently.

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Section: Figuresupporting

confidence: 51%

Section: Figurementioning

confidence: 82%

Severe ulcerations in corticosteroid‐induced striae distensae rubrae under anti‐vascular endothelial growth factor treatment of anaplastic astrocytoma

et al. 2020

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“…Estimates of the prevalence of stretch marks range from 50 to 80% (Atwal et al, 2006; Cho et al, 2006). Although stretch marks are only harmful in extreme cases (Dosal et al, 2012), even mild stretch marks can cause distress to the bearer.…”

mentioning

confidence: 99%

Genome-Wide Association Analysis Implicates Elastic Microfibrils in the Development of Nonsyndromic Striae Distensae

Tung

Kiefer

Mullins

et al. 2013

Journal of Investigative Dermatology

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“…Although SD are only harmful in extreme cases , they are disfiguring skin lesions which can cause serious psychological concerns and even mild lesions can cause distress to the bearer . However, despite the considerable investigations into their origins, the pathology of SD remains unknown and much research is needed.…”

Section: Discussionmentioning

confidence: 99%

Striae reconstructed, a full thickness skin model that recapitulates the pathology behind stretch marks

Pérez-Aso¹,

Roca²,

Bosch³

et al. 2019

Intern J of Cosmetic Sci

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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.

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Ulceration of Abdominal Striae Distensae (Stretch Marks) in a Cancer Patient —Quiz Case

Cited by 9 publications

References 0 publications

Severe ulcerations in corticosteroid‐induced striae distensae rubrae under anti‐vascular endothelial growth factor treatment of anaplastic astrocytoma

Severe ulcerations in corticosteroid‐induced striae distensae rubrae under anti‐vascular endothelial growth factor treatment of anaplastic astrocytoma

Genome-Wide Association Analysis Implicates Elastic Microfibrils in the Development of Nonsyndromic Striae Distensae

Striae reconstructed, a full thickness skin model that recapitulates the pathology behind stretch marks

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