Article Text

Download PDFPDF
A teenager with lumbar striae distensae (when a bruise is not a bruise)
  1. Noha Elshimy1,
  2. Anjum Gandhi2
  1. 1King George Hospital, Essex, UK
  2. 2Department of Paediatrics, Good Hope Hospital, Birmingham, UK
  1. Correspondence to Dr Noha Elshimy, noha.elshimy{at}


A 14-year-old boy was referred to a paediatric clinic after a recent diagnosis of coeliac disease, which was well controlled on a gluten-free diet. During the consultation, the mother raised concerns regarding marks that had developed over her son's back over the past 6 months. On examination, a number of horizontal, coloured bruise-like marks were noted over the lower back. The appearance was suspicious of bruising and possible non-accidental injury, although a history of trauma or injury was denied. Blood tests including a coagulation screen were arranged which were normal and the patient was followed up twice during a 6-month period. He remained well but the bruising was persistent. It was concluded that these were striae associated with pubertal growth. This case summarises the importance of careful surveillance of bruising in children and illustrates the association between striae and pubertal growth which may be confused with non-accidental injury.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.