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Mar 2012

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

Author Affiliations
 

SECTION EDITOR: MARY S. STONE, MD; ASSISTANT SECTION EDITORS: SOON BAHRAMI, MD; CARRIE ANN R. CUSACK, MD; SENAIT W. DYSON, MD; MOLLY A. HINSHAW, MD; ARNI K. KRISTJANSSON, MD

Arch Dermatol. 2012;148(3):385-390. doi:10.1001/archderm.148.3.385-c

A 32-year-old cushingoid man presented with a 2-month history of progressively enlarging deep tender ulcerations on his arms, abdomen, back, proximal legs, and beneath his panus. His medical history was significant for World Health Organization stage IV glioblastoma multiforme (GBM) treated with a regimen of etoposide and bevacizumab, as well as dexamethasone, 4 mg, twice daily to decrease cerebral edema. On examination, we found 35 ulcerations that were all localized on striae distensae. The ulcers had rolled violaceous borders and clean bases (Figure 1 and Figure 2). A complete blood cell count showed leukocytosis (white blood cell count, 14.3   ×  103/ μL), anemia (hemoglobin level, 11.4 g/dL), a positive antinuclear antibody titer (1:40), and a positive finding for anti-Sj ögren syndrome A (anti-SSA) antibodies. (To convert white blood cells to number of cells   ×  109/L, multiply by 0.001; to convert hemoglobin to grams per liter, multiply by 10.) A biopsy specimen was obtained and submitted for histopathologic evaluation (Figure 3).

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