3. Becker's Naevus

Becker's Naevus

This PatientPlus article is written for healthcare professionals so the language may be more technical than the condition leaflets. You may find the abbreviations list helpful.

Synonyms: Becker melanosis, pigmented hairy naevus of Becker

Becker's naevus is a form of epidermal naevus (birthmark). It usually appears around puberty as a hyperpigmented patch, most often found on the upper trunk or shoulders.[1][2][3]

BECKER'S NAEVUS -ON BACK

There is overgrowth of the epidermis (upper layers of the skin), pigment cells (melanocytes) and hair follicles. It may be due to a gene defect (as yet unidentified), perhaps triggered by circulating androgens, which would explain its onset during adolescence.

  • It is more common in men.
  • One study reported a prevalence of 0.52% in men aged 17-26 years.[4]

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  • A large brown area, sometimes covering half the upper back or chest. Most lesions become hairy (hypertrichosis).
  • After puberty it often becomes darker and expands, usually over a period of 1-2 years.
  • Occasionally acne may develop in the naevus.
  • Some fading (reduced pigmentation) may occur in adulthood.
  • One case of bilateral, symmetrical pigmentation is reported - this is unusual.[3]

The age of onset, site and the fixed nature of the lesion are usually enough to make the diagnosis.

  • McCune-Albright syndrome (with café-au-lait patches on the skin).
  • Pityriasis versicolor is usually symmetrical and slightly scaly.
  • Epidermis: acanthosis and hyperpigmentation of the basal layer, with elongation and fusion of adjacent rete ridges and variable hyperkeratosis.
  • Dermis: hyperplasia of the dermal smooth muscle and melanophages.
  • No treatment is necessary except for cosmetic reasons; usually reassurance and a diagnosis are enough.
  • For cosmetic treatment of the lesion:
    • Electrolysis or laser treatment may help with hair removal.
    • Laser treatment can sometimes reduce the pigmentation, but may be ineffective or may worsen the lesion.
    • Fractional resurfacing has also been used to lighten the lesions.[3]
  • For acne in the lesion, use standard acne treatments.
  • If there is doubt about the diagnosis (eg possible melanoma), urgent referral is appropriate.

The naevus remains indefinitely.[2]

This is a Becker's naevus with additional abnormalities of underlying tissues derived from ectoderm. It is a type of epidermal naevus syndrome. There may be underdevelopment or overdevelopment of underlying structures, including:

It is named after S. William Becker who first described the lesion in 1949. Becker naevus syndrome was described in 1995 by Happle.

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Further reading & references

  1. Becker Naevus, DermNet NZ, September 2010
  2. Becker's Naevus, DermIS (Dermatology Information System)
  3. Grim KD, Wasko CA; Symmetrical bilateral Becker melanosis: A rare presentation. Dermatol Online J. 2009 Dec 15;15(12):1.
  4. Tymen R, Forestier JF, Boutet B, et al; (Late Becker's nevus. One hundred cases (author's transl)). Ann Dermatol Venereol. 1981;108(1):41-6.
  5. Rivers JK et al; Becker Melanosis, Medscape, Apr 2010
  6. Cosendey FE, Martinez NS, Bernhard GA, et al; Becker nevus syndrome. An Bras Dermatol. 2010 Jun;85(3):379-84.
  7. Steiner D, Silva FA, Pessanha AC, et al; Do you know this syndrome? An Bras Dermatol. 2011 Feb;86(1):165-166.
Original Author: Dr Huw Thomas, Dr Richard Draper Current Version:
Last Checked: 23/05/2011 Document ID: 4062  Version: 22 © EMIS

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.

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