There are 4 causes of striae distensae:
1. Pregnancy (Stria gravidarum)
2. Obesity (Over-stretched skin)
3. Steroid induced: A. Cushing’s syndrome: Endogenous steroids excess
B. Corticosteroids (Systemic and/or topical) and sex steroid hormones : Exogenous steroids excess
4. Heavy-weight lifters (Sport): due to large muscle mass stretching the overlying skin and Occasionally there may be an additional role for anabolic steroids.
Predilection sites: generally skin overlying fat cushions (abdomen, buttocks, thighs, calf region, shoulders, over the biceps muscle and occasionally the back). Skin overlying bony areas seems to be exempted.
The presented case is a 24-year-old female presented with purplish linear atrophic areas involved many predilection sites but maximally over the calves (Photo) due to misused corticosteroids for 2 months to increase body weight.
N.B: Striae usually have purplish color in early stages (first few months) but later became narrower and whitish in color.