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Gaurav V, Ahuja R, Chandra AD, Ahuja S, Bhagwat A, Lal A, Danish M, Khan E, Taneja N. Follicular Becker's nevi: A case series and review of literature. Pediatr Dermatol 2024. [PMID: 38689523 DOI: 10.1111/pde.15641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 04/16/2024] [Indexed: 05/02/2024]
Abstract
The follicular variant of Becker's nevus is an under-reported entity. We present the rare occurrence of follicular Becker's nevus in 7 patients, confirmed through dermoscopy and histopathological examination. Dermoscopy shows perifollicular hypopigmentation surrounded by a well-defined net-like pigmentation corresponding clinically to the presence of folliculocentric macules. Histology shows prominent basal and suprabasal melanization surrounding the follicle, corresponding to well-defined net-like pigmentation seen on dermoscopy. However, the melanization does not extend along the entire length of the follicular epithelium leading to perifollicular hypopigmentation on dermoscopy. Though biopsy is confirmatory, it is not usually necessary.
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Affiliation(s)
- Vishal Gaurav
- Department of Dermatology & Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Rhea Ahuja
- Department of Dermatology & Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Akash Deep Chandra
- Department of Dermatology & Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Sana Ahuja
- Department of Pathology, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Abhishek Bhagwat
- Department of Dermatology & Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Ankur Lal
- Department of Dermatology & Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Mohammad Danish
- Department of Dermatology & Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Ejaz Khan
- Department of Dermatology & Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Neha Taneja
- Department of Dermatology & Venereology, All India Institute of Medical Sciences, New Delhi, India
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2
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S A, Wahab AJ, Jacob SM, R VC. Follicular Becker's Nevus: A Case Report of an Uncommon Clinical Variant. Cureus 2024; 16:e58264. [PMID: 38752066 PMCID: PMC11094524 DOI: 10.7759/cureus.58264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 04/13/2024] [Indexed: 05/18/2024] Open
Abstract
Pigmented hairy epidermal nevus, also known as Becker's nevus, has a typical description as a unilateral, hairy in appearance, light to dark brown patch with an irregular but clearly defined border. However, the exact aetiopathogenesis is still poorly comprehended. We report the case of a 19-year-old female who presented with asymptomatic brownish-pigmented macular lesions on the right breast that had slowly increased in size over the past three years. Upon cutaneous inspection, the right breast had 3-5 mm rounded and oval perifollicular macules that ranged from light to dark brown hue without increased hair growth. The macules were discrete and in no particular pattern. Dermoscopy of the lesions showed well-defined perifollicular hypopigmentation surrounded by a pigmented network-like pattern. Histopathology of a punch biopsy taken from one of the follicular lesions demonstrated an increase in basal layer pigmentation with elongation of rete ridges and acanthosis, consistent with Becker's nevus. The patient underwent three sittings of diode laser therapy, once in four weeks, with slight improvement in pigmentation.
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Affiliation(s)
- Anannya S
- Department of Dermatology, Saveetha Medical College, Chennai, IND
| | | | | | - Vimal Chander R
- Department of Pathology, Saveetha Medical College, Chennai, IND
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3
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Arvind MN, Rajanna AH, Kanth MS, Chandrashekar A. An uncommon presentation of segmental Becker's nevus involving the T4 dermatome. J Family Med Prim Care 2024; 13:1563-1565. [PMID: 38827700 PMCID: PMC11142011 DOI: 10.4103/jfmpc.jfmpc_1646_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 01/03/2024] [Accepted: 01/04/2024] [Indexed: 06/04/2024] Open
Abstract
This case report explores a rare manifestation of Becker's nevus, where the patient exhibited an unusual dermatomal distribution featuring a hyperpigmented, irregular patch with associated hypertrichosis on the T4 segment. While Becker's nevus is a well-known dermatological condition typically observed in the upper back region, instances of dermatomal distribution are exceptionally uncommon. This case presents a unique occurrence of segmental Becker's nevus, highlighting the atypical presentation of this condition.
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Affiliation(s)
- M N Arvind
- Department of General Medicine, Shri Atal Bihari Vajpayee Medical College and Research Institute (SABVMCRI), Bengaluru, Karnataka, India
| | - Avinash H. Rajanna
- Department of General Medicine, Shri Atal Bihari Vajpayee Medical College and Research Institute (SABVMCRI), Bengaluru, Karnataka, India
| | - Mahesh S. Kanth
- Department of General Medicine, Bangalore Medical College and Research Institute (BMCRI), Bengaluru, Karnataka, India
| | - Aditya Chandrashekar
- Department of General Medicine, Bangalore Medical College and Research Institute (BMCRI), Bengaluru, Karnataka, India
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4
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Zhang LW, Jiang CH, Li L, Chen T. Bilateral giant Becker's nevus. An Bras Dermatol 2023; 98:248-250. [PMID: 36697336 PMCID: PMC9984696 DOI: 10.1016/j.abd.2021.05.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/10/2021] [Accepted: 05/14/2021] [Indexed: 01/25/2023] Open
Affiliation(s)
| | | | | | - Tao Chen
- Department of Dermatovenereology, Chengdu Second People's Hospital, Chengdu, Sichuan, China.
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5
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Laser treatment of benign melanocytic lesion: a review. Lasers Med Sci 2022; 37:3353-3362. [PMID: 36097230 DOI: 10.1007/s10103-022-03642-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 09/06/2022] [Indexed: 10/14/2022]
Abstract
Treatment of pigmented lesions is one of the major challenges of laser and cosmetic practitioners. The most common pigmented lesions that are treated by lasers are melanocytic nevi, ephelides, solar lentigines, and café au lait macules. Melanin absorbs different wavelengths (500-1100 nm); thereby, treatment of various pigmented lesions requires the application of lasers with different wavelengths. Choosing the most appropriate type of laser depends on various factors such as the chromophore and the location of a specific lesion in the skin. In this paper, we aim to review the most efficient laser treatment protocols for each pigmented skin lesion and compare their efficacy in each part based on the previous studies.
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6
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Evaluating the Roles of Different Types of Laser Therapy in Becker’s Nevus Treatment. J Clin Med 2022; 11:jcm11144230. [PMID: 35887993 PMCID: PMC9324390 DOI: 10.3390/jcm11144230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/17/2022] [Accepted: 07/18/2022] [Indexed: 02/04/2023] Open
Abstract
Becker’s nevus (BN) is a cutaneous hamartoma of benign nature that develops through adolescence and affects mostly young men. The nevus is usually located unilaterally and is characterized by hypertrichosis and hyperpigmentation. Despite recent advances in treatment modalities, no effective treatment has been established for BN hyperpigmentation. We sought to assess the efficacy and safety of fractional Erbium: YAG 2940 nm and Q-switched Nd: YAG 1064 nm lasers in the treatment of BN hyperpigmentation. Twenty-three patients with BN were included in a prospective, randomized-controlled, observer-blinded, split-lesion comparative technique trial. In each patient, two similar square test regions were randomized to either be treated with a fractional Erbium: YAG 2940 nm laser or with a Q-switched Nd: YAG 1064 nm laser. Each patient was treated with three sessions at six-week intervals. At the follow-up, clearance of hyperpigmentation was assessed by physician global assessment, visual analogue scale, grade of improvement, patient global assessment, and patient satisfaction. Regions treated with the fractional Erbium: YAG 2940 nm laser demonstrated significantly better improvement compared to ones treated with the Q-switched Nd: YAG 1064 nm (p-value = 0.001) laser. Adverse effects such as repigmentation and hypertrophic scarring were not reported during the follow-up period. The outcomes were cosmetically acceptable with overall high satisfaction among the included patients. Our data suggest a superior role for the fractional Erbium: YAG (2940 nm) laser in the treatment of BN hyperpigmentation compared to the Q-switched Nd: YAG (1064 nm) laser, along with being a safer method and having no reported side effects.
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7
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Zhou YJ, Zheng DL, Hamblin MR, Xu YD, Wen X. An update on Becker's nevus: pathogenesis and treatment. Dermatol Ther 2022; 35:e15548. [PMID: 35502558 DOI: 10.1111/dth.15548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 04/19/2022] [Accepted: 04/28/2022] [Indexed: 02/05/2023]
Abstract
Becker's nevus (BN) manifests as a hyperpigmented, sometimes hypertrichotic plaque/patch over the chest and shoulder, and it is in the category of benign cutaneous hamartomas. BN has elongation and fusion of the rete ridge, keratotic plugging, sebaceous hyperplasia, smooth muscle hyperplasia, and hyperpigmentation of the basal/suprabasal layer histologically. This article highlights all issues involved in pathogenesis and treatment options of BN. According to current research, postzygotic ACTB mutations induce BN and Becker's nevus syndrome (BNS). Although several therapy strategies were utilized to treat the pigmentary and hypertrichotic aspects of BN, no definitive standard treatment was identified to far, and further research is needed to better educate BN care. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Yan Jun Zhou
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China.,Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Dan Ling Zheng
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China.,Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Michael R Hamblin
- Laser Research Centre, Faculty of Health Science, University of Johannesburg, Doornfontein, South Africa
| | - Yi Dan Xu
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China.,Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Xiang Wen
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China.,Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
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8
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ZANFRAMUNDO S, TONINI A, GUALTIERI B, GHIARA F, ROMANELLI M. Becker's nevus syndrome. Ital J Dermatol Venerol 2022; 156:14-15. [DOI: 10.23736/s2784-8671.18.06211-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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9
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Abstract
This article reviews the clinical findings of epidermal nevi and their associated syndromes and provides an update on their pathogenic genetic changes as well as targeted therapies detailed to date.
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10
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Chikani UN, Ohuche IN, Bisi-Onyemaechi AI. Becker's nevus syndrome: a case report. J Med Case Rep 2021; 15:395. [PMID: 34365967 PMCID: PMC8351151 DOI: 10.1186/s13256-021-02996-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Accepted: 07/02/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Becker's nevus syndrome is a syndrome characterized by the presence of a Becker's nevus with ipsilateral breast hypoplasia or hypoplastic defects of the muscle, skin, or skeleton. The nevus usually consists of a circumscribed, unilateral, irregularly shaped hyperpigmented macule, commonly occurring around the anterior upper trunk, with/without hypertrichosis and/or acneiform lesions. This rare syndrome has not been reported in our locality to the best of our knowledge. CASE PRESENTATION We report the case of a 15-year-old Igbo female patient who presented to our pediatric endocrinology clinic, University of Nigeria Teaching Hospital, Enugu, with complaints of asymmetry of the breasts and hyperpigmented macules on the side. Based on her symptoms, diagnosis of Becker's nevus syndrome was made. The diagnosis of Becker's nevus syndrome is mostly clinical, based on the presence of a Becker's nevus with ipsilateral breast hypoplasia or hypoplastic defects of the muscle, skin, or skeleton. In our patient, there was a Becker's nevus with ipsilateral breast hypoplasia. This syndrome, belonging to the class of epidermal nevus syndromes, is very rare, and is usually benign. She was placed on spironolactone tablets 50 mg daily, which have been associated with an improvement in the size of the hypoplastic breast, and her fears were allayed. CONCLUSION This syndrome has not been reported in our locality to the best of our knowledge and, therefore, has a propensity for misdiagnosis by clinicians because of its rarity. We therefore report this to create awareness among clinicians regarding this condition that is associated with much psychosocial trauma among patients, and that can be easily managed with oral spironolactone.
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Affiliation(s)
- Ugo N Chikani
- Endocrine unit, Department of Paediatrics, University of Nigeria, Ituku Ozalla, Enugu, Nigeria.
| | - Ijeoma N Ohuche
- Endocrine unit, Department of Paediatrics, University of Nigeria, Ituku Ozalla, Enugu, Nigeria
| | - Ada I Bisi-Onyemaechi
- Endocrine unit, Department of Paediatrics, University of Nigeria, Ituku Ozalla, Enugu, Nigeria
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11
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Torchia D. Becker nevus syndrome: A 2020 update. J Am Acad Dermatol 2021; 85:e101-e103. [PMID: 33819536 DOI: 10.1016/j.jaad.2021.03.095] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/21/2021] [Accepted: 03/24/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Daniele Torchia
- Department of Dermatology, James Paget University Hospital, Gorleston-on-Sea, Great Yarmouth, United Kingdom.
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12
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Krahl D. Testen Sie Ihr Fachwissen. AKTUELLE DERMATOLOGIE 2021. [DOI: 10.1055/a-1348-8942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- D. Krahl
- Institut für DermatoHistoPathologie Dres. Krahl & Partner, Heidelberg
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13
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Tirelli L, Label A, Luna P, Larralde M. Becker Nevus: 4 Cases of a Rare Syndrome. ACTAS DERMO-SIFILIOGRAFICAS 2021. [DOI: 10.1016/j.adengl.2021.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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14
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Christodoulides N, Kelly GA, O'Sullivan ST. Breast lipofilling as a treatment for breast hypoplasia in Becker naevus syndrome: a case report. J Surg Case Rep 2021; 2021:rjaa583. [PMID: 33542812 PMCID: PMC7850009 DOI: 10.1093/jscr/rjaa583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 12/15/2020] [Indexed: 01/30/2023] Open
Abstract
A Becker's naevus is a rare, pigmented, cutaneous hamartoma, which when associated with other cutaneous or musculoskeletal anomalies is termed Becker naevus syndrome. Female patients commonly seek medical attention for breast hypoplasia. Here, we describe our experience in the surgical management of unilateral breast hypoplasia in a patient with Becker naevus syndrome, using high-volume autologous fat grafting. This is, to our knowledge, the second report in the literature describing the aforementioned management technique in this patient cohort.
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Affiliation(s)
- Natasha Christodoulides
- Department of Plastic and Reconstructive Surgery, Cork University Hospital, Wilton, Cork, Ireland
| | - Gerard A Kelly
- Department of Plastic and Reconstructive Surgery, Cork University Hospital, Wilton, Cork, Ireland
| | - Sean T O'Sullivan
- Department of Plastic and Reconstructive Surgery, Cork University Hospital, Wilton, Cork, Ireland
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15
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Comprehensive Treatment of a Skeletal Class III Growing Patient with Alveolar Bone Hypertrophy in the Anterior Mandible Associated with Becker's Nevus Syndrome: A Case Report. CHILDREN-BASEL 2021; 8:children8020072. [PMID: 33494282 PMCID: PMC7909796 DOI: 10.3390/children8020072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/14/2021] [Accepted: 01/18/2021] [Indexed: 11/17/2022]
Abstract
Becker's nevus is a relatively common skin lesion with brown hyperpigmentation and hypertrichosis. It may be expressed simultaneously with other cutaneous, muscular, or skeletal defects, such as hypoplasia of the breast or scoliosis, for which the term "Becker's nevus syndrome" has been proposed. An 8-year-old boy presented with a Becker's nevus on the right cheek, chin, and upper neck with alveolar bone hypertrophy in the anterior mandible, which led to an anterior crossbite and severe canting of the mandibular anterior teeth. Through orthopedic treatment using a face mask, the anteroposterior jaw relationship was improved. In phase 2 treatment, we corrected the canting of the mandibular anterior teeth with a segmental intrusion of the mandibular anterior right teeth into the hypertrophic alveolar bone area. The facial profile was improved along with acceptable occlusion, and the treatment result was stable at 1 year after the end of the treatment, without any periodontal attachment loss, root resorption of mandibular anterior teeth, or increase in the size of the hypertrophic region. This case report describes the successful comprehensive treatment of a growing patient with skeletal Class III malocclusion and multiple characteristics of Becker's nevus syndrome.
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16
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Kumar P, Sanke S, Chander R, Nangia A. Becker's Nevus Coexisting with Morphea: A Rare Case Report. Skin Appendage Disord 2020; 7:46-49. [PMID: 33614719 DOI: 10.1159/000510675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 07/31/2020] [Indexed: 11/19/2022] Open
Abstract
Becker's nevus (BN) is an acquired unilateral hyperpigmented hairy macule, whereas morphea is a chronic connective tissue disease of unknown etiology, characterized by skin thickening with increased quantities of collagen in the indurated lesion, usually involving the upper trunk and proximal extremity. The occurrence of both disease in the same anatomical site and individual was not reported previously. We report this rare case in a 17-year-old, Indian girl and was diagnosed after clinical histopathology and dermoscopic correlation. Morphea can be an interesting incidental occurrence within a large plaque of BN.
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Affiliation(s)
- Pradeep Kumar
- Department of Dermatology & STD, Lady Hardinge Medical College and associated Hospital, Delhi, India
| | - Sarita Sanke
- Department of Dermatology & STD, Lady Hardinge Medical College and associated Hospital, Delhi, India
| | - Ram Chander
- Department of Dermatology & STD, Lady Hardinge Medical College and associated Hospital, Delhi, India
| | - Anita Nangia
- Department of Pathology, Lady Hardinge Medical College and associated Hospital, Delhi, India
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17
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Tirelli LL, Label A, Luna PC, Larralde M. Becker Nevus: 4 Cases of a Rare Syndrome. ACTAS DERMO-SIFILIOGRAFICAS 2020; 112:282-283. [PMID: 32553987 DOI: 10.1016/j.ad.2019.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 10/08/2019] [Accepted: 11/12/2019] [Indexed: 11/27/2022] Open
Affiliation(s)
- L L Tirelli
- Servicio de Dermatología, Hospital Alemán, Buenos Aires, Argentina.
| | - A Label
- Servicio de Dermatología, Hospital Alemán, Buenos Aires, Argentina
| | - P C Luna
- Servicio de Dermatología, Hospital Alemán, Buenos Aires, Argentina
| | - M Larralde
- Servicio de Dermatología, Hospital Alemán, Buenos Aires, Argentina
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18
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Segmental Ipsilateral Odontognathic Dysplasia (Mandibular Involvement in Segmental Odontomaxillary Dysplasia?) and Identification of PIK3CA Somatic Variant in Lesional Mandibular Gingival Tissue. Head Neck Pathol 2020; 15:368-373. [PMID: 32500425 PMCID: PMC8010023 DOI: 10.1007/s12105-020-01185-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Accepted: 05/29/2020] [Indexed: 10/24/2022]
Abstract
Segmental odontomaxillary dysplasia (SOD) is a developmental condition of the middle and posterior maxilla featuring dysplastic bone overgrowth, dental abnormalities and, occasionally, various homolateral cutaneous manifestations. Herein, we describe an individual with maxillary abnormality akin to SOD and associated ipsilateral segmental odontomandibular dysplasia. Also, the result of the evaluation of lesional mandibular gingival tissue for overgrowth-related gene variants is reported. An 8-year-old girl presented clinically with congenital maxillary and mandibular alveolar soft tissue enlargement in the area of the premolars. A panoramic radiograph revealed abnormal trabeculation essentially similar to SOD in the maxilla and mandible with congenitally missing maxillary and mandibular first and second premolars and mandibular canines. Diagnostic mandibular bone biopsy was performed and lesional mandibular gingival hyperplastic tissue was obtained for variant analysis of somatic overgrowth genes PIK3CA, AKT1, AKT3, GNAQ, GNA11, MTOR, PIK3R2. Cone beam computerized tomography (CBCT) disclosed osseous abnormalities on the left side of the maxilla and mandible and very mild osseous expansion in the mandible. Histologically, abnormal bone exhibiting prominent reversal lines was present and associated with fibrocollagenous tissue. Genomic DNA analysis disclosed PIK3CAc.1571G>A; pArg524Lys which was seen at a low mosaic level in the blood, indicating a post-zygotic change. Although this case may be a unique disorder, by sharing features with SOD, one can suggest the possibility of mandibular involvement in SOD. The presence of a PIK3CA variant may support the hypothesis that these segmental disorders could be part of the PIK3CA-related overgrowth spectrum.
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19
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Atzmony L, Ugwu N, Zaki TD, Antaya RJ, Choate KA. Post-zygotic ACTB mutations underlie congenital smooth muscle hamartomas. J Cutan Pathol 2020; 47:681-685. [PMID: 32170967 DOI: 10.1111/cup.13683] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 02/25/2020] [Accepted: 03/10/2020] [Indexed: 01/20/2023]
Abstract
BACKGROUND Congenital smooth muscle hamartomas (CSMHs) are benign lesions that share clinical and histopathological features with Becker nevus, a mosaic disorder associated with post-zygotic ACTB mutations. Given the clinical and histopathological overlap between CSMH and Becker nevus, we hypothesized that post-zygotic mutations in ACTB may underlie CSMH. METHODS Direct sequencing of ACTB gene in affected and unaffected tissue isolated from one case of hemihypertrichosis and hemihypertrophy corresponding to giant segmental CSMH and hemihypertrophy. This was followed by direct sequencing with and without enrichment assay for hotspot ACTB mutations in affected tissue from 12 samples of isolated CSMH from unrelated individuals. RESULTS In total we identified somatic missense ACTB mutations in 9 out of 13 CSMHs (69%). Mutations were either novel or previously reported in Becker nevi and Becker nevus syndrome. CONCLUSIONS CSMHs result from post-zygotic ACTB mutations. This study proves that CSMHs and Becker nevi are nosologically related, and expand the phenotypic spectrum of ACTB mutations.
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Affiliation(s)
- Lihi Atzmony
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut, USA.,Department of Genetics, Yale University School of Medicine, New Haven, Connecticut, USA.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nelson Ugwu
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Theodore D Zaki
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Richard J Antaya
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Keith A Choate
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut, USA.,Department of Genetics, Yale University School of Medicine, New Haven, Connecticut, USA.,Department of Pathology, Yale University School of Medicine, New Haven, Connecticut, USA
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20
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Manchanda Y, Khaitan BK, Ramam M, Das S, Al-Mutairi N. Follicular Becker's Nevus: A New Clinical Variant. Indian J Dermatol 2020; 65:130-132. [PMID: 32180599 PMCID: PMC7059461 DOI: 10.4103/ijd.ijd_476_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Becker's nevus, also known as pigmented hairy epidermal nevus, is characteristically described as a unilateral, hairy, light to dark brown macule with sharply outlined but irregular border. The etiopathogenesis of Becker's nevus is still not clearly understood. Perifollicular pigmentation has been described earlier by some authors. But, Becker's nevus presenting exclusively with follicular lesions has not been described. We are reporting a series of patients of Becker's nevus with follicular lesions. The diagnosis in all the patients was made after clinicopathological correlation. Follicular epithelium may hold a significant role in the etiopathogenesis of Becker's nevus.
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Affiliation(s)
- Yashpal Manchanda
- Department of Dermatology, Farwaniya Hospital, Kuwait University, Kuwait
| | - Binod K Khaitan
- Department of Dermatology and Venereology, AIIMS, New Delhi, India
| | - M Ramam
- Department of Dermatology and Venereology, AIIMS, New Delhi, India
| | - Sudip Das
- Department of Dermatology and Venereology, AIIMS, New Delhi, India
| | - Nawaf Al-Mutairi
- Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait
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21
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Lim YH, Burke AB, Roberts MS, Collins MT, Choate KA. Multilineage ACTB mutation in a patient with fibro-osseous maxillary lesion and pilocytic astrocytoma. Am J Med Genet A 2018; 176:2037-2040. [PMID: 30152002 DOI: 10.1002/ajmg.a.40475] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 06/20/2018] [Accepted: 06/22/2018] [Indexed: 01/17/2023]
Affiliation(s)
- Young H Lim
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut.,Department of Pathology, Yale University School of Medicine, New Haven, Connecticut.,Department of Genetics, Yale University School of Medicine, New Haven, Connecticut
| | - Andrea B Burke
- Skeletal Disorders and Mineral Homeostasis Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland.,Division of Oral and Maxillofacial Surgery, School of Dentistry, University of Washington, Seattle, Washington
| | - Mary S Roberts
- Skeletal Disorders and Mineral Homeostasis Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland
| | - Michael T Collins
- Skeletal Disorders and Mineral Homeostasis Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland
| | - Keith A Choate
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut.,Department of Pathology, Yale University School of Medicine, New Haven, Connecticut.,Department of Genetics, Yale University School of Medicine, New Haven, Connecticut
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22
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Cohen PR. Poland's Syndrome: Are Postzygotic Mutations in β-Actin Associated with its Pathogenesis? Am J Clin Dermatol 2018; 19:133-134. [PMID: 29139054 DOI: 10.1007/s40257-017-0330-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Philip R Cohen
- Department of Dermatology, University of California San Diego, 10991 Twinleaf Court, San Diego, CA, 92131-3643, USA.
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23
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Abstract
Knowledge of the molecular underpinnings of many epidermal nevi and epidermal nevus syndrome has expanded rapidly in recent years. In this review and update on epidermal nevus syndrome, we will cover recent genetic discoveries involving epidermal nevi, including nevus sebaceus, keratinocytic epidermal nevus, nevus comedonicus, congenital hemidysplasia with ichthyosiform nevus and limb defects syndrome, phakomatosis pigmentokeratotica, Becker's nevus, porokeratotic adnexal ostial nevus, inflammatory linear verrucous epidermal nevi, and cutaneous-skeletal hypophosphatemia syndrome. We will discuss how newly defined mutations relate to the biology reflected in the cutaneous patterns seen in these mosaic disorders and how new molecular data has informed our understanding of these diseases and shaped management decisions.
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Affiliation(s)
- Sarah Asch
- Department of Dermatology, HealthPartners and Park Nicollet Medical Groups, St. Paul, MN, USA
| | - Jeffrey L Sugarman
- Department of Dermatology, University of California, San Francisco, Santa Rosa, CA, USA.,Department of Community and Family Medicine, University of California, San Francisco, Santa Rosa, CA, USA
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24
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Kim YJ, Roh MR, Lee JH, Na JI, Ko JY, Jung JM, Lee JH, Chang SE. Clinicopathologic characteristics of early-onset Becker's nevus in Korean children and adolescents. Int J Dermatol 2017; 57:55-61. [DOI: 10.1111/ijd.13779] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 09/19/2017] [Accepted: 08/23/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Young J. Kim
- Department of Dermatology; Asan Medical Center; University of Ulsan College of Medicine; Seoul Korea
| | - Mi R. Roh
- Department of Dermatology; Gangnam Severance Hospital; Yonsei University College of Medicine; Seoul Korea
| | - Ji H. Lee
- Department of Dermatology; Gangnam Severance Hospital; Yonsei University College of Medicine; Seoul Korea
| | - Jung I. Na
- Department of Dermatology; Seoul National University Bundang Hospital; Gyeonggi-do Korea
| | - Joo Y. Ko
- Department of Dermatology; Hanyang University College of Medicine; Seoul Korea
| | - Joon M. Jung
- Department of Dermatology; Asan Medical Center; University of Ulsan College of Medicine; Seoul Korea
| | - Jong H. Lee
- Department of Dermatology; Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul Korea
| | - Sung E. Chang
- Department of Dermatology; Asan Medical Center; University of Ulsan College of Medicine; Seoul Korea
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25
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Cai ED, Sun BK, Chiang A, Rogers A, Bernet L, Cheng B, Teng J, Rieger KE, Sarin KY. Postzygotic Mutations in Beta-Actin Are Associated with Becker’s Nevus and Becker’s Nevus Syndrome. J Invest Dermatol 2017; 137:1795-1798. [DOI: 10.1016/j.jid.2017.03.017] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 02/20/2017] [Accepted: 03/01/2017] [Indexed: 11/29/2022]
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26
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Abstract
The etiology of Becker's nevus and Becker's nevus syndrome has been until now unknown. Cai et al. provide evidence that these disorders are caused by lethal mutations in ACTB, a gene coding for beta-actin. They hypothesize that these mutations may interfere with Hedgehog pathway signaling. Their findings have important implications for clinical genetics, and they open new aspects in hair research.
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27
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Becker nevus syndrome and ipsilateral breast hypoplasia: a systematic literature review. EUROPEAN JOURNAL OF PLASTIC SURGERY 2017. [DOI: 10.1007/s00238-017-1327-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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28
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Becker's Nevus Syndrome in a Pediatric Female Patient. Case Rep Pediatr 2016; 2016:3856518. [PMID: 27891278 PMCID: PMC5116335 DOI: 10.1155/2016/3856518] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 11/01/2016] [Indexed: 11/25/2022] Open
Abstract
Becker's nevus syndrome is part of the epidermal nevus syndromes and has been described with a phenotype that includes Becker's nevus, ipsilateral breast hypoplasia, and variable skeletal malformations. It is more frequent in males than in females (5 : 1) but is more relevant in females. The diagnosis is clinically based and the skin lesion must be present and no other numbered criteria have been established, but with more criteria being present the possibility of the diagnosis is higher. Regarding the treatment of breast hypoplasia, the use of antiandrogen medication has demonstrated adequate clinical response in a dose of 50 mg/day of spironolactone.
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29
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Ghosh SK, Majumder B, Agarwal M. Becker's nevus syndrome: a report of a rare disease with unusual associations. Int J Dermatol 2016; 56:458-460. [PMID: 27655000 DOI: 10.1111/ijd.13378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 02/23/2016] [Accepted: 05/10/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Sudip K Ghosh
- Department of Dermatology, Venereology, and Leprosy, R. G. Kar Medical College, Kolkata, India
| | | | - Megha Agarwal
- Department of Dermatology, Venereology, and Leprosy, R. G. Kar Medical College, Kolkata, India
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30
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Bruant-Rodier C, Dissaux C, Baratte A, Francois Fiquet C, Bodin F. [The breast of the adolescent girl]. ANN CHIR PLAST ESTH 2016; 61:629-639. [PMID: 27318639 DOI: 10.1016/j.anplas.2016.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 05/02/2016] [Indexed: 10/21/2022]
Abstract
During adolescence, psychological and physical changes occur and breast takes a major place in the young woman body image. Except rare malign tumors, breast pathologies at this age are mainly benign or malformative. Malformative issues are revealed during breast growth, as isolated asymmetry or associated to other regional anomalies, with abnormal shape or volume of the breast, or even supernumerary breast. Therapeutic solutions will not differ from the ones used for adults. Breast lipofilling, recently admitted by plastic surgery community is an interesting tool that can be used on young women. Choosing the right technic depends on the initial problem. It comes at an early stage to offset hypoplasia resulting in a problem of asymmetry. It waits for breast stability in case of hypertrophy and for legal majority in case of breast augmentation using implants. Psychological impairment stays however a central issue and forces the surgeon to adapt to the individual and to his body change over time.
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Affiliation(s)
- C Bruant-Rodier
- Service de chirurgie plastique, reconstructrice et esthétique, chirurgie B, hôpitaux universitaires, 1, place de l'Hôpital, 67091 Strasbourg cedex, France.
| | - C Dissaux
- Service de chirurgie plastique, reconstructrice et esthétique, chirurgie B, hôpitaux universitaires, 1, place de l'Hôpital, 67091 Strasbourg cedex, France
| | - A Baratte
- Service de chirurgie plastique, reconstructrice et esthétique, chirurgie B, hôpitaux universitaires, 1, place de l'Hôpital, 67091 Strasbourg cedex, France
| | - C Francois Fiquet
- Service de chirurgie plastique, centre hospitalier de Reims, 45, rue Cognacq Jay, 51100 Reims, France
| | - F Bodin
- Service de chirurgie plastique, reconstructrice et esthétique, chirurgie B, hôpitaux universitaires, 1, place de l'Hôpital, 67091 Strasbourg cedex, France
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31
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A novel mutation of the RNA-specific adenosine deaminase 1 gene in a Taiwanese patient with dyschromatosis symmetrica hereditaria and Becker's nevus-like lesion. DERMATOL SIN 2016. [DOI: 10.1016/j.dsi.2015.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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32
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Abstract
Neurocutaneous disorders are a heterogeneous group of conditions (mainly) affecting the skin [with pigmentary/vascular abnormalities and/or cutaneous tumours] and the central and peripheral nervous system [with congenital abnormalities and/or tumours]. In a number of such disorders, the skin abnormalities can assume a mosaic patterning (usually arranged in archetypical patterns). Alternating segments of affected and unaffected skin or segmentally arranged patterns of abnormal skin often mirror similar phenomena occurring in extra-cutaneous organs/tissues [eg, eye, bone, heart/vessels, lung, kidney and gut]. In some neurocutaneous syndromes the abnormal mosaic patterning involve mainly the skin and the nervous system configuring a (true) mosaic neurocutaneous disorder; or an ordinary trait of a neurocutaneous disorder is sometimes superimposed by a pronounced linear or otherwise segmental involvement; or, lastly, a neurocutaneous disorder can occur solely in a mosaic pattern. Recently, the molecular genetic and cellular bases of an increasing number of neurocutaneous disorders have been unravelled, shedding light on the interplays between common intra- and extra-neuronal signalling pathways encompassing receptor-protein and protein-to-protein cascades (eg, RAS, MAPK, mTOR, PI3K/AKT and GNAQ pathways), which are often responsible of the mosaic distribution of cutaneous and extra-cutaneous features. In this article we will focus on the well known, and less defined mosaic neurocutaneous phenotypes and their related molecular/genetic bases, including the mosaic neurofibromatoses and their related forms (ie, spinal neurofibromatosis and schwannomatosis); Legius syndrome; segmental arrangements in tuberous sclerosis; Sturge-Weber and Klippel-Trenaunay syndromes; microcephaly/megalencephaly-capillary malformation; blue rubber bleb nevus syndrome; Wyburn-Mason syndrome; mixed vascular nevus syndrome; PHACE syndrome; Incontinentia pigmenti; pigmentary mosaicism of the Ito type; neurocutaneous melanosis; cutis tricolor; speckled lentiginous syndrome; epidermal nevus syndromes; Becker's nevus syndrome; phacomatosis pigmentovascularis and pigmentokeratotica; Proteus syndrome; and encephalocraniocutaneous lipomatosis.
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Affiliation(s)
- Martino Ruggieri
- Department of Clinical and Experimental Medicine, Section of Pediatrics and Child Neuropsychiatry, University of Catania, Catania, Italy.
| | - Andrea D Praticò
- Department of Clinical and Experimental Medicine, Section of Pediatrics and Child Neuropsychiatry, University of Catania, Catania, Italy; Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
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33
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Bisht YS, Bhasin R, Manoj S, Sunita BS, Singhal E. Becker's nevus syndrome. Med J Armed Forces India 2015; 71:S89-91. [PMID: 26265883 DOI: 10.1016/j.mjafi.2013.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Accepted: 04/22/2013] [Indexed: 11/19/2022] Open
Affiliation(s)
- Y S Bisht
- Senior Advisor (Dermatology), Base Hospital, Lucknow, India
| | - Rohit Bhasin
- Classified Specialist (Dermatology & Venereology), Base Hospital, Lucknow, India
| | - S Manoj
- Classified Specialist (Medicine & Neurology), Command Hospital (Central Command), Lucknow, India
| | - B S Sunita
- Graded Specialist (Pathology), Command Hospital (Central Command), Lucknow, India
| | - Esha Singhal
- Resident (Dermatology & Venereology), Base Hospital, Lucknow, India
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34
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Patel P, Malik K, Khachemoune A. Sebaceus and Becker's Nevus: Overview of Their Presentation, Pathogenesis, Associations, and Treatment. Am J Clin Dermatol 2015; 16:197-204. [PMID: 25782676 DOI: 10.1007/s40257-015-0123-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Nevus sebaceus (NS) and Becker's nevus (BN) are two variants of epidermal nevi. NS clinically presents as a yellowish-orange, hairless plaque on the scalp, face, or neck, while BN presents as a tan-to-brown hyperpigmented, sometimes hypertrichotic, plaque typically on the chest and shoulder. Histologically, NS displays mature or nearly mature sebaceus glands as well as acanthosis and fibroplasia of the papillary dermis. BN shows variable papillomatosis, acanthosis, and hyperkeratosis, with hyperpigmentation of the basal/suprabasal layer. While the genetic basis of NS is thought to be due to post-zygotic mutations in the Harvey rat sarcoma viral oncogene homolog (HRAS)/Kristen rat sarcoma viral oncogene homolog (KRAS) genes, the genetic basis of BN is relatively unknown and is implicated with paradominant inheritance. In some patients, NS and BN can each be associated with additional cutaneous and extra-cutaneous anomalies, ranging from benign or malignant tumors to multiple organ irregularities. Due to the wide range of possible associations, treatment for NS and BN is devised on a case-by-case basis. In this article, we review the features, etiology, and diagnosis/management of NS and BN, with a focus on associations. We also report a patient who concomitantly presents with both lesions.
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Affiliation(s)
- Parth Patel
- Albert Einstein College of Medicine, Bronx, NY, USA
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35
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Ho Quoc C, Fakiha M, Meruta A, Dlimi C, Piat JM, Delay E. Breast lipofilling: A new treatment of Becker nevus syndrome. ANN CHIR PLAST ESTH 2015; 60:336-9. [PMID: 25746302 DOI: 10.1016/j.anplas.2015.02.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2014] [Accepted: 02/02/2015] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The association of Becker's nevus with other cutaneous, musculoskeletal or maxillofacial anomalies is called Becker nevus syndrome. Ipsilateral breast hypoplasia is the main reason for female patients to seek medical advice. We present two clinical cases of Becker nevus syndrome with thoracic nevus and ipsilateral breast hypoplasia treated with lipofilling alone (fat grafting). MATERIAL AND METHODS For the two consecutive cases of Becker nevus syndrome treated by fat grafts, we present the surgical technique and the outcome at one year follow-up. Fat was harvested with cannula after infiltration. The adipose tissue was prepared with a short centrifugation. Fat grafting was realized as backward injections. RESULTS We have noticed a concomitant improvement of the thoracic nevus color with a stable result after one-year follow-up. The aesthetic result after lipofilling was evaluated as very satisfying by the patient. The breast symmetry was improved. CONCLUSIONS We believe that the lipofilling technique is a natural and valuable treatment option for thoracic anomalies in Becker nevus syndrome with a major impact on patient's quality of life.
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Affiliation(s)
- C Ho Quoc
- Clinique du Val d'Ouest, 39, chemin de la Vernique, 69130 Écully, France; International Breast Institute of Orangerie, 11, rue Silbermann, 67000 Strasbourg, France.
| | - M Fakiha
- Léon Bérard Center, 28, rue Laennec, 69008 Lyon, France
| | - A Meruta
- Léon Bérard Center, 28, rue Laennec, 69008 Lyon, France
| | - C Dlimi
- Léon Bérard Center, 28, rue Laennec, 69008 Lyon, France
| | - J M Piat
- International Breast Institute of Orangerie, 11, rue Silbermann, 67000 Strasbourg, France
| | - E Delay
- Léon Bérard Center, 28, rue Laennec, 69008 Lyon, France
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36
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Abstract
The term epidermal nevus syndrome (ENS) has been used to describe the association of epidermal hamartomas and extracutaneous abnormalities. Although many continue to use the term "ENS," it is now understood that this is not one disease, but rather a heterogeneous group with distinct genetic profiles defined by a common cutaneous phenotype: the presence of epidermal and adnexal hamartomas that are associated with other organ system involvement. One commonality is that epidermal nevi often follow the lines of Blaschko and it appears the more widespread the cutaneous manifestations, the greater the risk for extracutaneous manifestations. The majority of the extracutaneous manifestations involve the brain, eye, and skeletal systems. The CNS involvement is wide ranging and involves both clinical manifestations such as intellectual disability and seizures, as well as structural anomalies. Several subsets of ENS with characteristic features have been delineated including the nevus sebaceus syndrome, Proteus syndrome, CHILD syndrome, Becker's nevus syndrome, nevus comedonicus syndrome, and phakomatosis pigmentokeratotica. Advances in molecular biology have revealed that the manifestations of ENS are due to genomic mosaicism. It is likely that the varied clinical manifestations of ENS are due in great part to the functional effects of specific genetic defects. Optimal management of the patient with ENS involves an interdisciplinary approach given the potential for multisystem involvement. Of note, epidermal nevi have been associated with both benign and malignant neoplasms, and thus ongoing clinical follow-up is required.
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Affiliation(s)
- Sarah Asch
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA
| | - Jeffrey L Sugarman
- Departments of Dermatology and Community and Family Medicine, University of California San Francisco, Santa Rosa, CA, USA.
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37
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Verma S, Sharma YK, Deo K, Gupta A. Becker nevus syndrome; probably the first report of concurrent acrally located congenital BN, soft tissue hypertrophy and fused carpal bones. J Eur Acad Dermatol Venereol 2014; 30:184-6. [PMID: 25176291 DOI: 10.1111/jdv.12695] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- S Verma
- Department of Dermatology, Dr. D.Y. Patil Medical College and Hospital, Pimpri, Pune, India
| | - Y K Sharma
- Department of Dermatology, Dr. D.Y. Patil Medical College and Hospital, Pimpri, Pune, India
| | - K Deo
- Department of Dermatology, Dr. D.Y. Patil Medical College and Hospital, Pimpri, Pune, India
| | - A Gupta
- Department of Dermatology, Dr. D.Y. Patil Medical College and Hospital, Pimpri, Pune, India
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Hypertrichosis Is Not so Prevalent in Becker's Nevus: Analysis of 47 Cases. ISRN DERMATOLOGY 2014; 2014:953747. [PMID: 24977050 PMCID: PMC4040207 DOI: 10.1155/2014/953747] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/16/2014] [Accepted: 03/09/2014] [Indexed: 11/29/2022]
Abstract
Becker's nevus is a relatively common cutaneous hamartoma, but is often overlooked or misdiagnosed. This nevus usually begins during the second decade of life as a circumscribed, hyperpigmented patch with irregular outline that gradually enlarges with associated hypertrichosis, developing several years later. The purpose of this study was to determine the prevalence of lesional hypertrichosis associated with Becker's nevus. Methods. 47 patients who had sharply demarcated brown patch with or without coarse hair, presence or enlargement of the lesion at the time of puberty, and compatible Wood's light examination were enrolled. Patients who had axillary freckling, previous skin inflammation, and gray pigmentation of the lesions were excluded. Results. In summary, the mean age of onset was 11.89 (range 0–19). The most commonly involved site was the arm (34%), followed by shoulder (23.4%), chest, face, flank, buttock, and leg. Lesional hypertrichosis was found in only 8 (17%) of the 47 patients. In 29 cases (61.7%) the lesions were in the right side of the body. Conclusion. Hypertrichosis was not so frequent among patients with Becker's nevus. There was a higher preponderance of the lesions on the right side.
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39
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Abstract
CME EDUCATIONAL OBJECTIVES: 1.Understand the clinical presentation of a Becker nevus.2.Describe the differential diagnosis for Becker nevus.3.Be able to discuss the appropriate management for a Becker nevus. A 9-year-old healthy male presented to the dermatology clinic for evaluation of lesions on his chest. The lesions were unilateral and had been present for at least 1 year. No lesion had been previously noted in the affected area. No treatments had been tried prior to presentation. The patient denied pruritus or pain. Review of systems, medical history, and family history were unremarkable.
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Affiliation(s)
- Benjamin Bohaty
- Department of Dermatology, Northwestern University Feinberg School of Medicine, USA
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40
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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; 29:571-4. [PMID: 22471889 DOI: 10.1111/j.1525-1470.2012.01734.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We performed a retrospective study covering a 10-year period (January 1997-January 2007) on children referred to our unit or followed up for Becker's nevus (BN). The aim of this study was to better define the characteristics of BN in childhood, when this hypermelanosis is more frequent than the limited number of studies might suggest. Our data show that BN in children has predilection sites similar to those in adults, but hypertrichosis is rarer. Sun exposure does not appear to play an etiopathogenetic role. The higher incidence in men reported in adult case studies was not found in children. During and after puberty, androgenic stimulation is known to play a pathogenetic role in BN, especially in men, but our cases were mostly younger than 6 years old.
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Affiliation(s)
- Annalisa Patrizi
- Section of Dermatology, Department of Internal Medicine, Aging and Nephrologic Diseases, University of Bologna, Bologna, Italy.
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41
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NAMKOONG S, KIM JY, GYE J, CHUNG J, HONG SP, PARK BC, KIM MH. Pigmented epithelioid melanocytoma developed in a patient with Becker nevus syndrome. J Dermatol 2012; 39:811-2. [DOI: 10.1111/j.1346-8138.2012.01527.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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42
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Park SBM, Song BH, Park EJ, Kwon IH, Kim KH, Kim KJ. A Case of Becker's Nevus with Osteoma Cutis. Ann Dermatol 2011; 23:S247-9. [PMID: 22148062 PMCID: PMC3229077 DOI: 10.5021/ad.2011.23.s2.s247] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2011] [Revised: 07/13/2011] [Accepted: 07/13/2011] [Indexed: 11/24/2022] Open
Abstract
Becker's nevus is a relatively common acquired focal epidermal melanotic hypermelanosis usually found in the region of the shoulder girdle of young men. Various skeletal malformations and cutaneous dermatoses have been reported in Becker's nevus. Osteoma cutis is a rare disorder characterized by compact bone formation in the dermis or subcutaneous tissue. Secondary ossification on nevi has been reported, but not with Becker's nevus. Herein, we report a case of Becker's nevus with accompanying osteoma cutis in an 18-year-old female.
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Affiliation(s)
- Sae Bo Mi Park
- Department of Dermatology, Hallym Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, Korea
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43
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Baeta IGR, Viotti CV, Pereira ACF, Costa Júnior SRD, Bittencourt FV. Becker's nevus syndrome: case report. An Bras Dermatol 2011; 85:713-6. [PMID: 21152801 DOI: 10.1590/s0365-05962010000500020] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2009] [Accepted: 01/29/2010] [Indexed: 11/22/2022] Open
Abstract
Becker's nevus is a hyperpigmented macula that is predominantly located on the anterior trunk or on the scapular region, frequently associated with hypertrichosis. The association of Becker's nevus with other cutaneous, musculoskeletal or maxillofacial anomalies has been called Becker's nevus syndrome. We report a case of a 16-year-old girl with a hyperpigmented macula which spread from her right anterolateral trunk to the inner part of her right thigh accompanied by ipsilateral mammary hypoplasia. The skin lesion started when the patient was seven years old when it was also noticed ipsilateral mammary hypoplasia. The histological exam confirmed the clinical hypothesis of Becker's nevus.
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44
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Steiner D, Silva FADME, Pessanha ACAF, Bialeski N, Feola C, Buzzoni CAB. Do you know this syndrome? Becker nevus syndrome. An Bras Dermatol 2011; 86:165-6. [PMID: 21437545 DOI: 10.1590/s0365-05962011000100032] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2009] [Indexed: 11/22/2022] Open
Abstract
Becker nevus syndrome is the association of Becker's nevus with breast hypoplasia and other ipsilateral bone or muscle changes. It is considered to be a hormone-dependent disorder caused by a disturbance in the activity of the androgen receptor that appears to be increased in Becker's nevus, which may influence the development of associated lesions. We present a relevant case of this syndrome due to the rare systematization of the lesions in addition to the exuberant extracutaneous involvement in this case.
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Cosendey FE, Martinez NS, Bernhard GA, Dias MFRG, Azulay DR. Becker nevus syndrome. An Bras Dermatol 2010; 85:379-84. [PMID: 20676475 DOI: 10.1590/s0365-05962010000300015] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2009] [Accepted: 11/27/2009] [Indexed: 11/21/2022] Open
Abstract
Becker nevus syndrome is a phenotype characterized by the fundamental presence of Becker's nevus with ipsilateral hypoplasia of the breast or other skin, skeletal and/or muscular disorders. This syndrome generally originates at birth, intensifies significantly in adolescence and is one of the syndromes that constitute epidermal nevus syndrome. To the best of our knowledge, this is the first case published in the Brazilian literature of Becker nevus syndrome associated with Becker's nevus, ipsilateral breast hypoplasia and scoliosis in a 14-year-old girl.
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Abstract
Nevi or nests of cells may be made up of a variety of cell types. The cell types that live in the epidermis include epidermal cells or keratinocytes, sebaceous glands, hair follicles, apocrine and eccrine glands, and smooth muscle cells. This article discusses epidermal or keratinocyte nevi, nevus sebaceous, nevus comedonicus, smooth muscle hamartomas, and inflammatory linear verrucous epidermal nevi. Syndromes associated with epidermal nevi are also reviewed.
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Happle R. The group of epidermal nevus syndromes Part I. Well defined phenotypes. J Am Acad Dermatol 2010; 63:1-22; quiz 23-4. [PMID: 20542174 DOI: 10.1016/j.jaad.2010.01.017] [Citation(s) in RCA: 130] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2009] [Revised: 01/09/2010] [Accepted: 04/23/2009] [Indexed: 11/20/2022]
Abstract
UNLABELLED The epidermal nevus syndromes represent a group of distinct disorders that can be distinguished by the type of associated epidermal nevus and by the criterion of presence or absence of heritability. Well defined syndromes characterized by organoid epidermal nevi include Schimmelpenning syndrome, phacomatosis pigmentokeratotica, nevus comedonicus syndrome, angora hair nevus syndrome, and Becker nevus syndrome. The molecular basis of these disorders has so far not been identified. By contrast, the group of syndromes characterized by keratinocytic nevi comprises three phenotypes with a known molecular etiology in the form of CHILD (congenital hemidysplasia with ichthyosiform nevus and limb defects) syndrome, type 2 segmental Cowden disease, and fibroblast growth factor receptor 3 epidermal nevus syndrome (García-Hafner-Happle syndrome), whereas Proteus syndrome is still of unknown origin. From this overview, it is clear that a specific type of these disorders cannot be classified by the name "epidermal nevus syndrome" nor by the terms "organoid nevus syndrome" or "keratinocytic nevus syndrome." LEARNING OBJECTIVES After completing this learning activity, participants should be able to distinguish nine different epidermal nevus syndromes by their characteristic features, understand the practical significance of avoiding terms like "epidermal nevus syndrome" or "keratinocytic nevus syndrome" to define any specific entity within this group of disorders, and differentiate between nonhereditary traits and those bearing a genetic risk because of either Mendelian or non-Mendelian inheritance.
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Affiliation(s)
- Rudolf Happle
- Department of Dermatology, University of Marburg, Marburg, Germany.
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Alhusayen R, Kanigsberg N, Jackson R. Becker nevus on the lower limb: case report and review of the literature. J Cutan Med Surg 2008; 12:31-4. [PMID: 18258146 DOI: 10.2310/7750.2007.00034] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Becker nevus is a hamartoma with brown hyperpigmentation and hypertrichosis that usually affects young males. It has a predilection for the upper half of the trunk and proximal upper extremity. OBJECTIVE This is a case report of a 38-year-old male with a Becker nevus without hypertrichosis on the lower limb and a review of the literature. RESULTS Including our case report, 12 cases of Becker nevus on the lower limb were identified in the English literature (8 males and 4 females). It has never been reported below the knee. In males, the lesion was not associated with other anomalies, and all but two showed hypertrichosis (six of eight). In 50% (two of four) of women, it was associated with localized lipoatrophy. In one woman, it presented without hypertrichosis. CONCLUSION The presence of Becker nevi on the lower limb is unusual, and hypertrichosis is not always a feature. Larger studies are required to look into the true prevalence of this presentation and its prognostic value as a marker for other anomalies.
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Affiliation(s)
- Raed Alhusayen
- The Ottawa Hospital Civic Campus, Division of Dermatology, Ottawa, ON, Canada.
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Kiliç A, Kaya I, Gül U, Soylu S, Gönül M, Demiriz M. Becker nevus on face with asymmetrical growth of beard hair. J Eur Acad Dermatol Venereol 2008; 22:246-7. [PMID: 18211427 DOI: 10.1111/j.1468-3083.2007.02301.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
A 14-year-old boy had giant confluent brown patches that were bilaterally distributed on his back, chest, and upper arms, and partially covered by dark coarse hairs. A clinical diagnosis of Becker nevus was made and confirmed histopathologically. We report this patient for the rarity of presentation. Different clinical features of Becker nevi, associated findings, differential diagnoses, and treatment options are discussed.
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Affiliation(s)
- Alireza Khatami
- Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran.
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