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Letter - Clinical
Bilateral giant Becker's nevus
Li-Wen Zhang, Cun-Huo Jiang, Lin Li, Tao Chen
Corresponding author
13980427003@163.com

Corresponding author.
Department of Dermatovenereology, Chengdu Second People’s Hospital, Chengdu, Sichuan, China
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Multiple brown macules with hypertrichosis on the chest&#44; shoulders&#44; upper arms and axillae&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 13-year-old boy presented with a 6-year history of multiple asymptomatic brown macules affecting the chest and scapular regions bilaterally&#46; The pigmentation gradually darkened and progressively involved the neck&#44; right forearm&#44; both shoulders&#44; upper arms&#44; and axillae &#40;<a class="elsevierStyleCrossRefs" href="#fig0005">Figs&#46; 1 and 2</a>&#41;&#46; Increased hairs were observed on the lesions &#46; No other accompanied abnormality of the skin or musculoskeletal system was found&#46; Familial and medical histories were unremarkable&#46; Laboratory investigations including complete blood cell count&#44; liver&#44; and renal function were all normal&#46; Radiography of the chest&#44; spine and upper extremities also showed no abnormality&#46; The histopathological examination revealed slight hyperkeratosis&#44; with acanthosis&#44; elongation&#44; and fusion of the epidermal ridges and hyperpigmentation of the basal layer &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#46; These features were suggestive of Becker&#8217;s nevus&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Becker&#8217;s nevus is a type of epidermal nevus&#44; characterized by a single hyperpigmented patch with or without hypertrichosis&#44; and predominantly involves the unilateral upper trunk&#44; scapular region&#44; or upper arm unilaterally&#44; the disorder most likely reflects mosaicism&#46; Becker&#8217;s nevus is an androgen-dependent lesion because it becomes more prominent after adolescence and tends to be more conspicuous in male patients because of increased hairiness of this area&#46; The male-to-female ratio was said to be 2&#58;1&#8764;5&#58;1&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a> However&#44; some authors believed that the true sex ratio may be 1&#58;1&#44; due to Becker&#8217;s nevus tends to be less conspicuous in female patients&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;3</span></a> The other pathogenetic hypothesis of Becker&#8217;s nevus was postzygotic mutations in beta-actin&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Multiple or bilateral Becker&#8217;s nevus is rarely reported in the literature&#46; We reviewed a total of 25 reported cases of bilateral Becker&#8217;s nevus recently&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> Among them&#44; the male-to-female ratio was 18&#58;7&#59; 10 cases presented a single giant coalescent lesion&#59; 15 cases were multiple separated lesions&#46; The lesion distribution presented as symmetrical or asymmetrical &#40;including 4 cases of checkerboard pattern&#41;&#46; Like common Becker&#8217;s nevus&#44; the majority of bilateral Becker&#8217;s nevus manifested in adolescence&#44; and only a few patients present at birth or shortly after birth&#46; There were 6 cases with extracutaneous abnormalities&#44; so-called Becker&#8217;s nevus syndrome&#44; including breast hypoplasia&#44; musculoskeletal defects&#44; mental retardation&#44; and cardiac defects&#46; The incidence of Becker&#8217;s nevus syndrome appears to be higher in bilateral Becker&#8217;s nevus&#46; Therefore&#44; patients with a diagnosis of bilateral Becker&#8217;s nevus should undergo clinical evaluation for extracutaneous involvement&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Financial support</span><p id="par0020" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Authors&#8217; contributions</span><p id="par0025" class="elsevierStylePara elsevierViewall">Li-Wen Zhang and Cun-Huo Jiang contributed equally to this work&#46; Li-Wen Zhang&#58; Study conception and planning&#44; preparation and writing of the manuscript&#46; Cun-Huo Jiang&#58; Acquisition of data&#46; Lin Li&#58; Literature review&#46; Tao Chen&#58; Approval of the final version of the manuscript&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflicts of interest</span><p id="par0050" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span></span>"
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ISSN: 03650596
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