Differential Diagnosis
- Becker nevus
- Giant congenital nevus
- Epidermal nevus
- Café au lait macule
Diagnosis
The patient’s symptoms are indicative of Becker nevus, a benign, melanocytic epidermal proliferation of adolescence.
Discussion
Becker nevus, also known as Becker melanosis, appears most often in teenage boys, though it can also occur in females of similar age. Typically, lesions are present before puberty but often have increased coarse hair growth and a slightly raised texture during adolescence due to androgen stimulation. Rarely, there can be associated hypoplasia of the underlying tissues (eg, breast hypoplasia, pectoralis hypoplasia, or limb hypoplasia).
Most Becker nevi have no associated abnormalities. Treatment is required only in rare cases for severe cosmetic or psychosocial reasons.
Other rare associated findings include acne, acanthosis nigricans, spina bifida, scoliosis, pectus carinatum, accessory scrotum, lipoatrophy, and congenital adrenal hyperplasia. A few cases of melanoma in association with a Becker nevus have been reported.
Acknowledgment: Image courtesy of Logical Images, Inc. (www.VisualDx.com/JUCM).