Cutaneous Expression of Estrogen, Androgen and Glucocorticoid Receptors in Striae Distensae

Background: Osteoarthrosis (OA) of the knee is a leading cause of impaired mobility. Patients with knee OA have pain and limitations in the functions that prevent them from engaging in their usual functional activities. Purpose: This study was conducted to investigate the effect of combined dense disperse current through electroa-cupuncture with therapeutic exercises on pain, range of motion, and functional limitation in patients with knee OA. Subjects: Forty patients with knee OA their age ranged 38-50 years with mean of (42.13±3.66) and their BMI below 30kg/m2 with mean of (26.23±2.48) were randomly distributed into two equal groups. Material and Methods: Single u Background: Stretch marks or striae distensae (SD) can be considered a common skin disorder, but their physiopatho-genic mechanisms have not been totally clarified. Although itis considered an esthetic complaint, it may have serious psychosocial consequences besides the local and systemic alterations of the conjunctive tissue. This study aims at assessing and quantifying the estrogen, androgen and glucocorticoid receptors in skin samples with striae and comparing with normal skin. Methods: Skin samples for biopsy were obtained from thirty patients with (SD) (10) patients following systemic corticosteroid therapy and (10) patients following pregnancy, and (10) from obese patients and (20) normal controls. Tissue specimens were immediately fixed in neutral buffered formalin (10%) for 24 hours and underwent processing to assess histo-pathological features by H E stain for all slides to be studied by ordinary microscopy and to estimate Estrogen, Androgen and Glucocorticoid receptors expressions by immunohis-tochemical analysis as anti-Estrogen anti-androgen were performed for all biopsies using Avidine-Biotin complex technique while anti glucocorticoid was performed for all biopsies using (AEC) technique. Results: When the estrogen receptor in the skin with (SD) was compared with healthy skin, it was significantly higher in healthy skin than skin with (SD), while it was found that androgen and glucocorticoid were higher in skin with (SD) than healthy skin. Conclusions: These findings indicate that regions under-going greater mechanical stretching of the skin may have altered hormonal receptor expression and this varied expression may influence the metabolism of the extracellular matrix, causing the formation of (SD). The preliminary results appeared to be relevant and represented an initial step towards an understanding of the pathophysiology of (SD). se stainless steel needles and EA device were used. The experimental group (A) received combined dense disperse current through electroacupuncture with therapeutic exercises. The control group (B) received the same exercises only. Pain was measured by modified visual analog scale (VAS), knee ROM was measured by Myrin goniometer, and functional activity level was determined by the WOMAC scale before and after 12 sessions. Results: There was a significant difference between the two groups in post treatment measurement; the experimental group had significant decrease in pain intensity level and the limitation of functional performance than the control group and significant increase in knee ROM; active and passive flexion and extension than the control group. Conclusion: Combined dense disperse current through with therapeutic exercises proved to be beneficial in improving perceived knee pain, range of motion and decreasing the limitation of functional performance more than therapeutic exercises only in patients with knee OA.