Close
New

Medscape is available in 5 Language Editions – Choose your Edition here.

 

Becker Melanosis Workup

  • Author: Jason K Rivers, MD, FRCPC; Chief Editor: Dirk M Elston, MD  more...
 
Updated: Jun 03, 2016
 

Procedures

Skin biopsy provides histologic diagnosis of Becker nevus and helps distinguish it from other clinical entities.

Next

Histologic Findings

The epidermis demonstrates mild acanthosis and hyperkeratosis with regular elongation of rete ridges, as shown in the image below.

Becker nevus demonstrating smooth muscle bundles i Becker nevus demonstrating smooth muscle bundles in the dermis. Courtesy of Jason K. Rivers, MD.

The basal layer demonstrates hyperpigmentation resulting from increased melanin. Although often normal in number, an increase in the number of basal melanocytes occasionally can be detected.

Ultrastructurally, melanosomes are increased in keratinocytes, and giant melanosomes may be found in both keratinocytes and melanocytes.

Melanophages are present in the superficial dermis. Clinical hypertrichosis correlates with an increased number of morphologically normal follicular units. Almost every case demonstrates at least a slight increase in dermal smooth muscles.

Patches associated with smooth muscle hamartoma demonstrate more pronounced smooth muscle bundles irregularly dispersed within the dermis and unrelated to either hair follicles or vascular channels.

Previous
 
 
Contributor Information and Disclosures
Author

Jason K Rivers, MD, FRCPC Clinical Professor, Department of Dermatology and Skin Science, University of British Columbia Faculty of Medicine; Consulting Staff, Vancouver General Hospital and St Paul's Hospital; Medical Director, Pacific Dermaesthetics

Jason K Rivers, MD, FRCPC is a member of the following medical societies: American Academy of Dermatology, American Society for Dermatologic Surgery, Royal College of Physicians and Surgeons of Canada, British Columbia Medical Association, Canadian Dermatology Association, American Society for Laser Medicine and Surgery, Canadian Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Michael J Wells, MD, FAAD Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine

Michael J Wells, MD, FAAD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Texas Medical Association

Disclosure: Nothing to disclose.

Lester F Libow, MD Dermatopathologist, South Texas Dermatopathology Laboratory

Lester F Libow, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, Texas Medical Association

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Acknowledgements

Günter Burg, MD Professor and Chairman Emeritus, Department of Dermatology, University of Zürich School of Medicine; Delegate of The Foundation for Modern Teaching and Learning in Medicine Faculty of Medicine, University of Zürich, Switzerland

Günter Burg, MD is a member of the following medical societies: American Academy of Dermatology, American Dermatological Association, International Society for Dermatologic Surgery, North American Clinical Dermatologic Society, and Pacific Dermatologic Association

Disclosure: Nothing to disclose.

Marni C Wiseman, MD, FRCPC Assistant Professor, CancerCare Manitoba, University of Manitoba Faculty of Medicine

Marni C Wiseman, MD, FRCPC is a member of the following medical societies: Canadian Dermatology Association and Canadian Medical Association

Disclosure: Nothing to disclose.

References
  1. Becker SW. Concurrent melanosis and hypertrichosis in a distribution of nevus unius lateris. Arch Dermatol. 1948. 60:155-60.

  2. Grande Sarpa H, Harris R, Hansen CD, Callis Duffin KP, Florell SR, Hadley ML. Androgen receptor expression patterns in Becker's nevi: an immunohistochemical study. J Am Acad Dermatol. 2008 Nov. 59(5):834-8. [Medline].

  3. Fretzin DF, Whitney D. Familial Becker's nevus. J Am Acad Dermatol. 1985 Mar. 12(3):589-90. [Medline].

  4. Sirka CS, Puhan MR, Behera S, Mohanty P, Nanda M. Becker's nevus with ipsilateral breast hypoplasia. Indian J Dermatol Venereol Leprol. 2009 Mar-Apr. 75(2):202-3. [Medline].

  5. Van Gerwen HJ, Koopman RJ, Steijlen PM, Happle R. Becker's naevus with localized lipoatrophy and ipsilateral breast hypoplasia. Br J Dermatol. 1993 Aug. 129(2):213. [Medline].

  6. Lambert JR, Willems P, Abs R, Van Roy B. Becker's nevus associated with chromosomal mosaicism and congenital adrenal hyperplasia. J Am Acad Dermatol. 1994 Apr. 30(4):655-7. [Medline].

  7. Urbani CE, Betti R. Polythelia within Becker's naevus. Dermatology. 1998. 196(2):251-2. [Medline].

  8. Szylit JA, Grossman ME, Luyando Y, Olarte MR, Nagler H. Becker's nevus and an accessory scrotum. A unique occurrence. J Am Acad Dermatol. 1986 May. 14(5 Pt 2):905-7. [Medline].

  9. Kopera D, Hohenleutner U, Landthaler M. Quality-switched ruby laser treatment of solar lentigines and Becker's nevus: a histopathological and immunohistochemical study. Dermatology. 1997. 194(4):338-43. [Medline].

  10. Nelson JS, Applebaum J. Treatment of superficial cutaneous pigmented lesions by melanin-specific selective photothermolysis using the Q-switched ruby laser. Ann Plast Surg. 1992 Sep. 29(3):231-7. [Medline].

  11. Raulin C, Schönermark MP, Greve B, Werner S. Q-switched ruby laser treatment of tattoos and benign pigmented skin lesions: a critical review. Ann Plast Surg. 1998 Nov. 41(5):555-65. [Medline].

  12. Trelles MA, Allones I, Moreno-Arias GA, Vélez M. Becker's naevus: a comparative study between erbium: YAG and Q-switched neodymium:YAG; clinical and histopathological findings. Br J Dermatol. 2005 Feb. 152(2):308-13. [Medline].

  13. Choi JE, Kim JW, Seo SH, Son SW, Ahn HH, Kye YC. Treatment of Becker's nevi with a long-pulse alexandrite laser. Dermatol Surg. 2009 Jul. 35(7):1105-8. [Medline].

  14. Lapidoth M, Adatto M, Cohen S, Ben-Amitai D, Halachmi S. Hypertrichosis in Becker's nevus: effective low-fluence laser hair removal. Lasers Med Sci. 2014 Jan. 29(1):191-3. [Medline].

  15. Meesters AA, Wind BS, Kroon MW, Wolkerstorfer A, van der Veen JP, Nieuweboer-Krobotová L. Ablative fractional laser therapy as treatment for Becker nevus: a randomized controlled pilot study. J Am Acad Dermatol. 2011 Dec. 65(6):1173-9. [Medline].

  16. Balaraman B, Friedman PM. Hypertrichotic Becker's nevi treated with combination 1,550 nm non-ablative fractional photothermolysis and laser hair removal. Lasers Surg Med. 2016 Apr. 48 (4):350-3. [Medline].

 
Previous
Next
 
Becker nevus of chest wall with associated hypertrichosis. Courtesy of Jason K. Rivers, MD.
Becker nevus demonstrating smooth muscle bundles in the dermis. Courtesy of Jason K. Rivers, MD.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.