Becker Nevus in Focus: Clinical and Histopathological Insights with a Pattern of Epidermal Pigmentation Mimicking Regional Fitzpatrick Type VI Skin Implant
Becker Nevus
DOI:
https://doi.org/10.66344/jpad.v36i3.3462Keywords:
Becker nevus, Becker melanosis, Negroid Mosaicism, HypertrichosisAbstract
Background Becker nevus is an uncommon form of acquired cutaneous malformation marked by a unilateral, pigmented patch frequently accompanied by an excessive hair growth later on. It usually observed on the upper chest, scapular region, and proximal portions of the arms.
Objective To redefine the clinical and histopathological assessment of Becker nevus.
Methods This descriptive case study included patients of all ages, both sexes, clinically and histopathologically diagnosed with Becker nevus. A careful physical examination was conducted. Wood's light examination, as well as skin biopsy by a 5-mm punch was obtained.
Results The higher age of onset was during the second decade of life. A positive family history was reported in 7.6% of cases, while consanguinity was present in 15.4% of patients, and the congenital presentation was detected in 3.8% of cases. The hypertrichosis was presented in 63.5% of cases. The histopathology showed hyperkeratosis and acanthosis, while the melanin store was only epidermal while the dermal element was almost lacking.
Conclusion Becker nevus is a relatively frequent among the Iraqi population. It could be considered as localized Fitzpatrick type VI skin implanted in Fitzpatrick type II-IV person with increased epidermal melanin storage. Eastern and Western populations showed comparable findings, except for the higher frequency of consanguinity and positive family history.
References
1. Torchia D. Becker nevus syndrome: a 2020 update. J Am Acad Dermatol. 2021;85(2):e101-e103.
2. Antunes-Duarte S, Bouceiro-Mendes R, Fraga A, Soares-de-Almeida L. One person, two bilateral symmetrical giant Becker nevi. Dermatol Online J. 2020;26(9):13030.
3. Danarti R, König A, Salhi A, Bittar M, Happle R. Becker's nevus syndrome revisited. J Am Acad Dermatol. 2004;51(6):965-9.
4. Patrizi A, Medri M, Raone B, Bianchi F, Aprile S, Neri I. Clinical characteristics of Becker’s nevus in children: report of 118 cases from Italy. Pediatr Dermatol. 2012;29(5):571-4.
5. Kaliyadan F, Ashique KT. Becker melanosis. StatPearls [Internet]: StatPearls Publishing; 2022. https://www.ncbi.nlm.nih.gov/books/NBK435999/
6. Tripathy S, Warbasse E, Ronen S, Al-Rohil R, Cohen GF, Chen W-S, et al. Clinicopathologic correlation of dermatologic diseases in patients with darker pigmentation. Am J Clin Pathol. 2024;162(2):115-40.
7. Hurbain I, Romao M, Sextius P, Bourreau E, Marchal C, Bernerd F, et al. Melanosome distribution in keratinocytes in different skin types: melanosome clusters are not degradative organelles. J Investigative Dermatol. 2018;138(3):647-56.
8. Panigrahi A, Sil A. Becker Melanosis. Indian Pediatrics. 2020;57(6):597-8.
9. Raboudi A, Litaiem N. Congenital smooth muscle hamartoma. StatPearls [Internet]: StatPearls Publishing; 2023 https://www.ncbi.nlm.nih.gov/books/NBK545188/.
10. Lopez-Balboa P, Knöpfel N, Ramwani M, Muwanga-Nanyonjo N, O’Neill C, Lomas D, et al. Becker naevi are associated with neurologic abnormalities. J Am Acad Dermatol. 2025;92(4):887-90.
11. Abdulwahab RA, Banjar TA, Alharbi EA, Banjar T, Alhazmi Sr EA. Bilateral, symmetrical, congenital becker’s nevus melanosis: a rare presentation and review of the literature. Cureus. 2023;15(2):e34594.
12. Al-Bakaa MK, Al-Dhalimi MA, Dube P, Khalaf FK. Evaluating the roles of different types of laser therapy in Becker’s nevus treatment. J Clin Med. 2022;11(14):4230.
13. Bhardwaj M, Joshi A, Chakole S, Goel DB, Sardesai A. Becker’s Nevus in a Male: A Case Report. Cureus. 2023;15(9):e45005.
14. Sharquie KE, Noaimi AA, Al-Shukri MA. Melasma, Melasma-Like Lichen Planus Actinicus, and Butterfly Lichen Planus Actinicus Build up One Spectrum (Clinico-Histopathological Study). J Cosmet Dermatol Sci Appl. 2015;5(3):212-22.
15. Ingordo V, Gentile C, Iannazzone S, Cusano F, Naldi L. The ‘EpiEnlist’project: a dermo‐epidemiologic study on a representative sample of young Italian males. Prevalence of selected pigmentary lesions. J Eur Acad Dermatol Venereol. 2007;21(8):1091-6.
16. Zhou YJ, Zheng DL, Hamblin MR, Xu YD, Wen X. An update on Becker's nevus: Pathogenesis and treatment. Dermatol Therapy. 2022;35(7):e15548.
17. Zhong Y, Huang L, Chen Y, Yan T, Yang B, Man M-Q. 755-nm Q-switched alexandrite laser does not markedly benefit Becker’s nevus: a retrospective analysis of 59 cases. Lasers Med Sci. 2021;36(3):699-702.
18. Dehghanbanadaki H, Kim B, Fendereski K, Horns JJ, Ramsay JM, Jimbo M, et al. Racial/Ethnic differences in male reproductive health: a systematic review and meta-analysis of semen parameters and hormonal profiles in the United States. Int J Impot Res. 2025;37(12):950-64.
19. Hayashida MZ, Enokihara MMSeS, Hikawa RS, Cestari SdCP. Acne arising on a facial Becker nevus following the lines of Blaschko. An Bras Dermatol. 2017;92(5):740-2.
20. Zhu J, Zhu Y, Qu Z, Chang R, Lin X. A Pediatric Case of Becker Nevus Syndrome With Limb Overgrowth and Microvascular Malformation Associated With a Post‐Zygotic ACTB Variant. Int J Dermatol. 2026;65(7):1519-22.
21. AlGhamdi KM, AlKhalifah AI, AlSheikh AM, AlSaif FM. Clinicopathologic profile of Becker's melanosis with atypical features. J Drugs Dermatol. 2009;8(8):745-8.
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Copyright (c) 2026 Khalifa E Sharquie , Thamir A Kubaisi, Khalid M Awad
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