Becker's naevus

Latest update 15/03/11

This chapter is set out as follows:

Aetiology

Becker’s naevus is a relatively common, benign condition present in about 0.5% of young men
It is mainly a sporadic finding
Becker's naevus is an epidermal naevus of late onset caused by an overgrowth of the epidermis and hair follicles
It has been suggested that local androgen hypersensitivity is the major aetiological factor

History

Clinical findings

Distribution - predominantly the shoulder, anterior chest and scapular region. Although lesions have occasionally been reported in other areas
Morphology
- The first changes seen are the development of irregular areas of macular pigmentation
- Lesions fuse to form a large patch of pigmentation, which tends to be quite uniform in colour. The colour is often quite pale but become darker when exposed to the sun
- Over time a significant overgrowth of thick, dark hair is seen and the skin texture becomes thickened towards the centre
Becker’s naevus is usually an isolated phenomenum, however non-cutaneous abnormalities have been associated such as the underdevelopment of underlying structures or other tissues e.g. unilateral hypoplasia of the breast in females or the pectoralis major muscle

Management

Treatment of these lesions is very difficult and for most there is no satisfactory outcome
Protecting the affected area from the sun will keep the lesion paler and so make it stand out less. Cosmetic camouflage may be used but is often unsatisfactory as a result of the excess hair
Physical methods of hair removal may be of benefit and are not harmful
Laser therapy has been used but results are often disappointing

	Figure 1 - Becker's naevus A relatively early stage (copied with kind permission from Dermatoweb)
	Figure 2 - Becker's naevus Coarse hair has started to develop
	Figure 3 - Becker's naevus at an atypical site (copied with kind permission from Dermatoweb)