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CASE REPORT
Year : 2014  |  Volume : 15  |  Issue : 3  |  Page : 125-126

A typical Becker's nevus at an atypical site in a female child


Department of Dermatology, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India

Date of Web Publication30-Oct-2014

Correspondence Address:
Gurumoorthy Rajesh Kumar
No. 84, 4th Main Road, Chellampapu Nagar, Reddiyar Palayam, Puducherry - 650 010
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2319-7250.143668

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  Abstract 

Becker's nevus is an acquired and persistent asymmetrical area of skin pigmentation sometimes showing evidence of increased androgen sensitivity which typically occurs, postpuberty. Though the usual site is described as shoulder, anterior chest, or scapular region, it can occur over other unusual sites as well. We report such a rarer presentation of Becker's nevus on leg in a young female.

Keywords: Becker′s nevus, female, leg


How to cite this article:
Kumar GR, Karthikeyan K, Sengottian KL, Tejaswi C. A typical Becker's nevus at an atypical site in a female child. Indian J Paediatr Dermatol 2014;15:125-6

How to cite this URL:
Kumar GR, Karthikeyan K, Sengottian KL, Tejaswi C. A typical Becker's nevus at an atypical site in a female child. Indian J Paediatr Dermatol [serial online] 2014 [cited 2022 Jan 16];15:125-6. Available from: https://www.ijpd.in/text.asp?2014/15/3/125/143668


  Introduction Top


Becker's nevus is an acquired and persistent asymmetrical area of skin pigmentation sometimes showing evidence of increased androgen sensitivity in the form of increased hair growth and acneiform eruptions which typically occurs postpuberty. Though the usual site is described as shoulder, anterior chest, or scapular region, it can occur over unusual sites such as face, neck, abdomen, and thighs. Reports of it occurring over legs are very few. We report such a rarer presentation of Becker's nevus in a young female.


  Case report Top


A 14-year-old female child presented with a slowly growing asymptomatic dark hairy patch over right lower leg for 1-year. Patient reported a preexisting small black patch since childhood at the same site. On examination, a single large well-defined hyperpigmented patch of size 18 cm × 10 cm with irregular geographic border was present over the posterior aspect of right leg. Blotchy pigmentation was present at the periphery of the patch. Increased hair density and few acneiform papules were observed over the patch [Figure 1]. Histopathological examination of biopsy specimen showed hyperkeratosis, acanthosis, and heavy pigmentation of basal keratinocytes with melanophages in the upper dermis [Figure 2]. Bone survey of ipsilateral lower limb with X-ray and computed tomography scan showed no abnormality.
Figure 1: (a) Hyperpigmented patch with geographic borders. (b) Few acneiform papules and increased hair density over the patch

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Figure 2: (a) Elongated rete ridges with increased pigment in the basal layer (H and E, ×10). (b) Increase pigment in the basal layer and few melanophages in the upper dermis (×40)

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  Discussion Top


Becker's nevus was first described by William Becker in the year 1949 as "Concurrent melanosis and hypertrichosis in distribution of nevus unius lateris." In his report, he described it as an acquired localized melanosis occurring on various parts of the body. [1] This nevus is variously called as pigmented hairy epidermal nevus, Becker's melanosis. Cutaneous mosaicism has been proposed as the etiology of Becker's nevus. It is prone to acne and hypertrichosis due to the presumed androgen sensitivity in the patch. It can be associated with ipsilateral cutaneous and noncutaneous abnormalities such as breast hypoplasia, supernumerary nipples, aplasia of pectoralis major muscle, limb hypoplasia, segmental odonto maxillary hypoplasia, and lipoatrophy. Becker's nevus occurring in association with ipsilateral noncutaneous abnormalities is called as Becker's nevus syndrome. [2]

One of the largest series of Becker's nevus reported by Tymen et al. estimated the prevalence to be 0.52% among men. [3] It occurs five times more commonly in men. It presents as a unilateral irregular area of hyperpigmentation with geographic contour which usually occurs over shoulder and anterior chest.

There are various reports of Becker's nevus occurring over atypical sites such as face, neck, and limbs. In a case series, Becker's nevus was reported to occur at various atypical sites such as flank, pubic area, right arm, upper leg. [4] Becker's nevus rarely occurs in the lower limb. In a Jordanian survey done among males, they reported a prevalence of 6.5% of which only 1.1% of males showed localization of Becker's nevus over legs. [5] Manoj et al. reported a male patient with Becker's nevus occurring over knee joint. [6] Turan et al. reported it occurring on ankle in a male patient. [7]

It is intriguing to note that a typical Becker's nevus with hypertrichosis and acneiform eruption occurring in a female at an unusual site as this, has not been reported in the literature.

 
  References Top

1.Becker SW. Concurrent melanosis and hypertrichosis in distribution of nevus unius lateris. Arch Dermatol 1949;60:155.  Back to cited text no. 1
    
2.Moss C, Shahidullah H. Rook′s Text Book of Dermatology. 8 th ed. West Sussex: Blackwell Publishing Ltd.; 2010.  Back to cited text no. 2
    
3.Tymen R, Forestier JF, Boutet B, Colomb D. Late Becker′s nevus. One hundred cases (author′s transl). Ann Dermatol Venereol 1981;108:41-6.  Back to cited text no. 3
[PUBMED]    
4.Alfadley A, Hainau B, Al Robaee A, Banka N. Becker′s melanosis: A report of 12 cases with atypical presentation. Int J Dermatol 2005;44:20-4.  Back to cited text no. 4
    
5.Qa AS. Prevalence and clinical characteristics of Becker′s Nevi in young Jordanian males. J R Med Serv 2013;20:57-62.  Back to cited text no. 5
    
6.Manoj J, Kaliyadan F, Hiran KR. Atypical presentation of Becker′s melanosis. Indian Dermatol Online J 2011;2:42-3.  Back to cited text no. 6
[PUBMED]  Medknow Journal  
7.Turan H, Uslu E, Gun E. A below-knee Becker nevus: An unusual presentation. Abant Med J 2013;2:68-9.  Back to cited text no. 7
    


    Figures

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