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The exact etiology still remains controversial and this is partly due to the variability in the clinical situations in which striae arise. They are the end result of various physiologic states, including pregnancy, adrenocortical excess and changes in body habitus, as seen in rapid weight change. A genetic predisposition is presumed; striae distensae have been reported in monozygotic twins. There is decreased expression of collagen and fibronectin genes in affected tissue. The role of genetic factors is further emphasized by the fact that they are common in inherited defects of connective tissue, as in Marfan’s syndrome.