Stellate pseudoscars are white, irregular, star-shaped or linear atrophic lesions on the extensor forearms and hands. They are thought to occur secondary to skin tears in areas of skin fragility and are often preceded by hemorrhage into the dermis.

Stellate pseudoscars commonly occur after the age of 65 years and affect more than 20% of individuals over the age of 70 years.  They occur more commonly in chronically sun-exposed skin and are less common in individuals with darker skin colors. Older adults and young patients with prolonged topical corticosteroid use are at increased risk of developing this condition.

Pathogenetically, it is thought that CD44, a cell surface receptor of hyaluronate in the dermis, is decreased by long-term ultraviolet A (UVA) and UVB exposure. The resulting fragility places aged skin at greater risk for skin tears from minor trauma and the development of stellate pseudoscars where these tears heal.