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Description

      A 48- year- female with type 2 diabetes mellitus since 12 years presented in Medicine OPD of Hamdard Institute of Medical Sciences and Research and Associated HAH Centenary Hospital, Jamia Hamdard, New Delhi with signs of congestive heart failure. She had multiple abdominal striae which were slightly pale in colour as compared to nearby normal skin. Few of these striae were raised and mulberry like, boggy and cystic on touch (Figure 1). X- Ray chest showed marked cardiomegaly with cardiothoracic ratio as 0.65 (Figure 2) and echo revealed global hypokinesia with left ventricular ejection fraction of 20%. She was put on loop diuretics and aldactone along with insulin. Edema of striae reduced during her hospital stay of around 10 days and on follw up raised and peculiar appearance has disappeared.

      It seems that patient developed stretch marks over anterior abdominal wall during five gestations she had gone through. Now as she had developed features of congestion and that has led to these peculiar changes to already present striae.

      It is proposed that oedematous abdominal striae in multiparous females can be inferred as an additional marker of fluid overload state. This can also be used as a guide for optimal and judicious diuretic therapy.