Cushing’s syndrome is the most common cause of purple lines. If a patient presents with a combination of centripetal obesity, full-moon face, acne, increased blood pressure, menstrual disorders, sexual dysfunction and muscle atrophy of the extremities in addition to purple lines, consider Cushing’s syndrome as a possibility.
If the patient does not have any of these signs and symptoms, but mainly presents with rapid weight or height gain, consider localised conditions of increased skin pressure, such as puberty and excessive obesity.
Pregnant women may also develop purple lines due to the rapid growth of the foetus in the abdomen and increased abdominal pressure.
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