Published on 18/03/2015 by admin
Filed under Dermatology
Last modified 18/03/2015
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Michael P. Loosemore, Adisbeth Morales-Burgos, Elnaz F. Firoz, Bahar F. Firoz and Leonard H. Goldberg
Evidence Levels: A Double-blind study B Clinical trial ≥ 20 subjects C Clinical trial < 20 subjects D Series ≥ 5 subjects E Anecdotal case reports
Becker’s nevus, also called pigmented hairy epidermal nevus, is a cutaneous hamartoma that can have increased epidermal (melanocyte), dermal (smooth muscle), and appendageal (hair follicle) components. Classically, Becker’s nevus is first noticed around puberty on the shoulders and chest in males, but may be congenital, involve any area of the body, and occur in women. The prevalence in postpubertal males is approximated to be 0.5%, or 1 in 200.
Becker’s nevus is usually asymptomatic and may come to the attention of a physician for cosmetic or diagnostic purposes. It is important to examine the patient for developmental defects that may accompany Becker’s nevus and occur within the spectrum of Becker’s nevus syndrome, one of several epidermal nevus syndromes. Reported associations include, but are not limited to:
Cutaneous
– acneiform eruptions
– hypohidrosis
– lichen planus
– localized lipoatrophy
– localized scleroderma
– polythelia (supernumerary nipples)
– psoriasiform dermatitis
– unilateral breast hypoplasia
– osteoma cutis
Musculoskeletal
– limb asymmetry
– pectus excavatum or carinatum
– scoliosis, including other vertebral defects
Associations of Becker’s nevus with cutaneous cancers have been reported. Both basal cell carcinoma and intraepithelial squamous cell carcinoma (Bowen’s disease) have been described separately in two young women without significant risk factors (i.e., photodamage, papillomavirus infection, arsenic exposure). Although melanoma has been described in patients with Becker’s nevus, the risk of malignant transformation appears to be very low. Regular screening for melanoma is unnecessary.
Traditional surgical approaches to remove Becker’s nevus are either unsuccessful or result in significant scarring. Laser technology offers the clinician a means to reduce both the pigmentation and the hypertrichosis often seen in Becker’s nevus, and therefore may improve the cosmetic appearance of the lesion. Management of asymptomatic, benign lesions should be based on confirming the diagnosis and fully documenting any associated pathology.
Danarti R, König A, Salhi A, et al. J Am Acad Dermatol 2004; 51: 965–9.
A review of ipsilateral breast hypoplasia, other cutaneous anomalies, musculoskeletal abnormalities, and maxillofacial findings that may be observed in Becker’s nevus syndrome. The concept of paradominant inheritance is presented to explain occasional familial aggregation in this syndrome.
Happle R, Koopman RJ. Am J Med Genet 1997; 68: 357–61.
Proposes term ‘Becker nevus syndrome’ to describe association of Becker’s nevus with developmental defects such as unilateral breast hypoplasia and other cutaneous, muscular, or skeletal defects in 23 cases.
Fehr B, Panizzon RG, Schnyder UW. Dermatologica 1991; 182: 77–80.
Report of nine patients with Becker’s nevus and malignant melanoma. Five melanomas were on the same body site as the Becker’s nevus, but only one arose within the nevus itself.
Park SB, Song BH, Park EJ, Kwon IH, Kim KH, Kim KJ. Ann Dermatol 2011; 23 (Suppl 2): S247–9.
An 18-year-old female was reported to have osteoma cutis accompanying her Becker’s nevus.
Treatment of Skin Disease Comprehensive Therapeutic Strategies 4e
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