Ulceration in Striae Gravidarum in a Primigravida: A Rare Dermatological Complication in Pregnancy

Abstract

Striae gravidarum are common cutaneous changes of pregnancy and usually present as linear atrophic scars over areas exposed to progressive skin stretching. Ulceration within striae gravidarum is rare, particularly in the absence of systemic illness or documented corticosteroid exposure. This case report describes a 20-year-old primigravida who presented at 34 weeks of gestation with painful ulcers confined to pre-existing striae over the lower abdomen and upper thighs. The lesions were preceded by mild pruritus and erythema. Clinical evaluation showed no systemic symptoms, mucosal lesions or evidence of widespread dermatosis. Routine haematological and biochemical investigations, serum fasting cortisol and relevant serological tests were within normal limits, and swab culture from the ulcer base showed only commensal flora. The lesions were managed conservatively with saline dressings, topical antibiotic ointment and gentle emollient care. Healing occurred within two weeks, leaving atrophic scars, although two milder ulcers recurred near term and were again managed conservatively. The patient subsequently delivered a healthy term neonate by uncomplicated vaginal delivery, and postpartum follow-up showed complete resolution without new lesions. This case highlights spontaneous dehiscence of striae gravidarum as a rare but benign pregnancy-associated presentation. Recognition of this entity may help clinicians avoid unnecessary aggressive treatment while ensuring appropriate dermatological referral and counselling on safe topical product use during pregnancy.