Hindawi Publishing Corporation Case Reports in Pediatrics Volume 2013, Article ID 386094, 3 pages http://dx.doi.org/10.1155/2013/386094 Case Report Physiological Striae Atrophicae of Adolescence with Involvement of the Upper Back Alexander K. C. Leung 1 and Benjamin Barankin 2 1 Department of Pediatrics, the University of Calgary, the Alberta Children’s Hospital, No. 200, 233–16th Avenue NW, Calgary, AB, Canada T2M 0H5 2 Toronto Dermatology Centre, Toronto, ON, Canada M3H 5Y8 Correspondence should be addressed to Alexander K. C. Leung; aleung@ucalgary.ca Received 10 May 2013; Accepted 7 July 2013 Academic Editors: R. Broadbent and K.-H. Lue Copyright © 2013 A. K. C. Leung and B. Barankin. his is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. We report a 13-year-old boy with multiple purplish, atrophic, horizontal linear striae in the thoracic area. He reported a growth spurt in the preceding 12 months. His past health was unremarkable, and he took no medications. To our knowledge, physiological striae atrophicae of adolescence where idiopathic striae were restricted to the upper back have rarely been reported. Physiological striae atrophicae of adolescence may, on occasions, be mistaken for child abuse. It is important that child care professionals recognize this condition so that false accusations of child abuse will not be made. 1. Introduction Physiological striae atrophicae of adolescence occurs mainly in healthy, nonobese individuals at around puberty in asso- ciation with the adolescent growth spurt. he development of striae coincides with the markers of adolescence such as testicular enlargement, breast development, pubic hair growth, and menarche. By deinition, there is no identiiable underlying cause such as an endocrine or connective tissue disorder. he condition is more common in boys, presumably because boys grow faster than girls at around puberty. he onset of striae is usually between 14 and 20 years of age in males and 10 and 16 years of age in females [1]. We describe a 13-year-old boy with physiological striae atrophicae of adolescence presenting with multiple transverse striae on the upper back. To our knowledge, physiological striae of adolescence where idiopathic striae were restricted to the upper back have rarely been reported. 2. Case Report A 13-year-old boy presented with multiple transverse striae on the upper back. he striae were irst noted six months ago. here was no history of trauma, excessive physical exertion, or weight liting. He was otherwise healthy and was not taking medications. he child had gained 10.9 kg and had grown 15.8 cm over the preceding 12 months. No family members had similar skin lesions. On examination, his weight was 55 kg (75th percentile) and height 160 cm (50th percentile). His heart rate was 68 beats per minute and blood pressure 110/70 mm Hg. Multiple purplish, atrophic, horizontal linear striae were noted at the back in the thoracic area (Figure 1). His pubic hair was in the Tanner stage 3 of development. He had testicular enlargement compatible with his chronological age. he penile size was normal for his age. He had some acne on his forehead. He also had axillary hair. he rest of the physical examination was unremarkable. 3. Discussion Physiological striae atrophicae of adolescence typically presents as red or purple, horizontal, linear streaks (striae rubra) in the lumbar area [2]. Over time, the color fades and the lesions become atrophic and silvery (striae alba). hey are usually several cm long and 1 to 10 mm wide, with the long axis perpendicular to the direction of skin tension