Differential Diagnosis

• Single most likely diagnosis
  • Striae distensae: This condition is characterized by violaceous atrophic striations, often seen in areas of rapid growth or stretching of the skin, such as the posterior axillary folds in tall, slender individuals. The patient's recent growth spurt and lack of endocrine complaints support this diagnosis.
• Other Likely diagnoses
  • Cushing's syndrome: Although the patient has no endocrine complaints, Cushing's syndrome can cause striae, particularly in the axillary folds. However, the normal IGF-1 levels and lack of other symptoms make this less likely.
  • Marfan syndrome: This genetic disorder can cause skin manifestations, including striae, due to the patient's tall, slender stature. However, other systemic features of Marfan syndrome are not mentioned.
• Do Not Miss
  • Cushing's syndrome: As mentioned earlier, Cushing's syndrome is a potentially life-threatening condition that requires prompt diagnosis and treatment. Although the patient's IGF-1 levels are normal, it is essential to consider this diagnosis due to the potential severity of the condition.
  • Ehlers-Danlos syndrome: This group of genetic disorders can cause skin hyperextensibility and fragility, leading to striae. While less likely, it is crucial to consider this diagnosis due to the potential for significant complications.
• Rare diagnoses
  • Ehlers-Danlos syndrome, hypermobile type: This subtype of Ehlers-Danlos syndrome can cause skin manifestations, including striae, although it is less common.
  • Lipoatrophic diabetes: This rare condition can cause insulin resistance, leading to striae, although it is typically associated with more severe metabolic disturbances.