الفهرس 
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Abstract
striae distensae is a challenging cosmetic problem for which various treatment modalities have been applied. To compare between the efficacy and tolerability of intradermal injection of autologous platelet‐rich plasma (PRP) combined fractional CO2 laser vs. fractional CO2 laser alone in the treatment of striae distensae. Thirty patients with SD (rubra and alba) were randomly assigned to two groups. In each patient, pairs of SD on both sides of the midline with similar shape and approximately symmetrical site were selected and assigned to group A (treated with fractional CO2 laser combined with intradermal injection of PRP and group B(treated with fractional CO2 laser alone), Each patient underwent four sessions at 4‐week interval. The response to treatment was assessed with photographs taken for each patient before every session and three months after the last one. In addition, quartile grading scale and patient satisfaction score were done three month after the last session. Skin biopsies were taken from some patients at baseline, and 3 months after the last sessions stained with hematoxylin and eosin stain. The participating patients included 30 females and with age ranged from 16-27 years old with the mean age was 20.13 ± 3.05. The type of the lesion in 17 patients was alba (56.7%) and the type in the remaining 13 patients was rubra (43.3%). Fitzpatrick skin phototype of the patients were III, IV and the duration of disease ranged from 2 to 24 months with mean duration ± SD of 8.77 ± 6.74 months.Weight gain was the most prevalent precipitating factor (18 patients, 60%) followed by systemic steroid usage (6 patients, 20%). Other precipitating factors including weight loss, SG and topical steroid usage. There was statistically significant clinical improvement of SD in patients treated with PRP combined with fractional CO2 laser (group A) than patients treated with fractional CO2 laser (group B). According to quartile grading, excellent improvement was obtained in 12 patients (40%) in group A and 3 patients (10%) in group B, marked improvement obtained in 4 patients (20%) in group A and 10 patients (33.3%) in group B, moderate improvement obtained in 7 patients (23.3%) in group A and 6 patients (20%) in group B, mild improvement occurred in only 2 patients (6.7%) in group A and 8 patients (26.7%) in group B. Patients’ satisfaction was higher in group A compared with group B but was not statistically significant. In group A, 33.3% of the patients (10 patients) were very satisfied, 26.7% (8 patients) were satisfied, 30% reported slight satisfaction (9 patients) and 3 patients were unsatisfied with their improvement (10%). In group B, 13.3% (4 patients) was very satisfied, 8 patients (26.7%) were satisfied, also 26.7% reported slight satisfaction (8 patients) and 33.3% (10 patients) are unsatisfied. On the histopathology point of view, SR before treatment showed that the epidermis devoid of rete ridges. There is no increase in pigmentation of basal cell keratinocytes. Dermal edema. Predominance of fine dermal elastic fibers. After treatment microscopic examination of Sections from group A showed significant visible rete ridges, thin randomly arranged collagen and elastin fibers in papillary dermis and thick collagen bundles in the reticular dermis more than group B. Histopathological features of SA before treatment showed that the epidermis shows epidermal atrophy with loss of rete ridges. There is no increase in pigmentation of basal cell keratinocytes. Densely packed collagen fibers aligned parallel to dermal-epidermal junction. Microscopic examination of Sections from group A showed significant visible rete ridges, thin randomly arranged collagen and elastin fibers in papillary dermis and thick collagen bundles in the reticular dermis more than group B