LAUSR

Dear Editor, Striae are one of the common and unsightly cutaneous adverse drug reactions of long-term application of topical steroids. Striae rubra, striae alba, striae atrophicans, striae distensae, striae nigra, and striae cearulea are documented in English dermatology literature. The most common variants striae rubra and striae alba are commonly seen in the groin, flanks, abdomen, proximal thighs, breasts (in females), and axillae. Common causes for formation of striae include physiological changes at puberty and adolescence, obesity, pregnancy, oral and parenteral steroids, and Cushing’s disease. A rare variant of striae reported in literature is “edematous striae” in patients of nephrotic syndrome and lupus nephritis, many receiving high doses of oral steroids, in protein-losing enteropathy and increased fluid load in cardiac failure. Such patients frequently have hypoalbuminemia and at times anasarca. The aspirated fluid from the striae is usually serous or serosanguinous. The analysis of the fluid confirms a transudate by its low protein content completely different from lymphatic fluid. Dermatology literature has been flooded with articles on the epidemic-like situation of superficial dermatophytosis being fueled by abuse of fixed-dose combination (FDC) creams containing potent topical steroid, antifungal, and antibacterial agents. An overwhelming majority of patients report using these FDCs for periods ranging from 2 to 3 weeks to several months or years, either erratically or regularly and very commonly present with multiple cutaneous adverse reactions including striae. Dermatologists in India therefore are examining the inguinal region much more patients owing to the fact that tinea cruris is one of the commonest presentations of dermatophytosis in the country. We describe “pseudoedematous striae” as a hitherto undescribed variant of striae seen in the groin and upper thighs of overweight