Becker's Nevus Syndrome

Abstract

The simultaneous occurrence of a patch of light or dark brown hyperpigmentation with hypertrichosis (Becker's nevus) together with (usually ipsilateral) soft tissues hypoplasia (especially breast, in women) and underlying skeletal anomalies (i.e., vertebral hypoplasia, scoliosis, pectus carinatum or excavatum) represents the Becker's nevus syndrome (BNS) phenotype. It was first described (as a single cutaneous lesion) by Becker in 1949 and then associated with the surrounding musculoskeletal disorders. The syndrome has also been reported as pigmentary hairy epidermal nevus syndrome. Less than 100 cases have been reported in the literature, with a slightly higher incidence in females and only few familiar cases: paradominant postzygotic mutations and/or an androgen-dependent hyperactivation have been reported as the causes of the diseases.

The extracutaneous lesions are congenital and nonprogressive, and the natural history of the Becker's nevus is the same as that of isolated nevi: in prepubertal boys, the pigmentation may be less intense and the hairiness may be absent or mild, as occurs in women, whereas in men, there is an increase of hairiness after puberty. The treatment is essentially cosmetic, and potential therapeutic options include electrolysis, waxing, makeup, or laser.

Keywords

Becker's nevus - hyperpigmentation - hypertrichosis - soft tissues hypoplasia - skeletal abnormalities

^* Both authors contributed equally to the manuscript.

• References

• 1 Tymen R, Forestier JF, Boutet B, Colomb D. Late Becker's nevus. One hundred cases [article in French]. Ann Dermatol Venereol 1981; 108 (01) 41-46
• 2 Danarti R, König A, Salhi A, Bittar M, Happle R. Becker's nevus syndrome revisited. J Am Acad Dermatol 2004; 51 (06) 965-969
• 3 Happle R, Koopman RJ. Becker nevus syndrome. Am J Med Genet 1997; 68 (03) 357-361
• 4 Sugarman JL. Epidermal nevus syndromes. Semin Cutan Med Surg 2004; 23 (02) 145-157
• 5 Patrizi A, Medri M, Raone B, Bianchi F, Aprile S, Neri I. Clinical characteristics of Becker's nevus in children: report of 118 cases from Italy. Pediatr Dermatol 2012; 29 (05) 571-574
• 6 Van Gerwen HJ, Koopman RJ, Steijlen PM, Happle R. Becker's naevus with localized lipoatrophy and ipsilateral breast hypoplasia. Br J Dermatol 1993; 129 (02) 213
• 7 Glinick SE, Alper JC, Bogaars H, Brown JA. Becker's melanosis: associated abnormalities. J Am Acad Dermatol 1983; 9 (04) 509-514
• 8 Ruggieri M, Polizzi A. From Aldrovandi's “Homuncio” (1592) to Buffon's girl (1749) and the “Wart Man” of Tilesius (1793): antique illustrations of mosaicism in neurofibromatosis?. J Med Genet 2003; 40 (03) 227-232
• 9 Ruggieri M, Praticò AD, Caltabiano R, Polizzi A. Rediagnosing one of Smith's patients (John McCann) with “neuromas tumours” (1849). Neurol Sci 2017; 38 (03) 493-499
• 10 Ruggieri M, Praticò AD, Scuderi A, Sorge G, Polizzi A. The multiple faces of artwork diagnoses. Lancet Neurol 2017; 16 (06) 417-418
• 11 Ruggieri M, Praticò AD, Caltabiano R, Polizzi A. Early history of the different forms of neurofibromatosis from ancient Egypt to the British Empire and beyond: first descriptions, medical curiosities, misconceptions, landmarks, and the persons behind the syndromes. Am J Med Genet A 2018; 176 (03) 515-550
• 12 Ruggieri M, Praticò AD, Serra A. , et al. Early history of neurofibromatosis type 2 and related forms: earliest descriptions of acoustic neuromas, medical curiosities, misconceptions, landmarks and the pioneers behind the eponyms. Childs Nerv Syst 2017; 33 (04) 549-560
• 13 Ruggieri M, Gabriele AL, Polizzi A. , et al. Natural history of neurofibromatosis type 2 with onset before the age of 1 year. Neurogenetics 2013; 14 (02) 89-98
• 14 Ruggieri M, Polizzi A, Spalice A. , et al. The natural history of spinal neurofibromatosis: a critical review of clinical and genetic features. Clin Genet 2015; 87 (05) 401-410
• 15 Ruggieri M, Praticò AD, Evans DGE. Diagnosis, management and new therapeutic options in childhood neurofibromatosis type 2 and related disorders. Semin Pediatr Neurol 2015; 22 (04) 240-258
• 16 Ruggieri M, Praticò AD, Serra A. , et al. Childhood neurofibromatosis type 2 (NF2) and related disorders: from bench to bedside and biologically targeted therapies. Acta Otorhinolaryngol Ital 2016; 36 (05) 345-367
• 17 Caltabiano R, Magro G, Polizzi A. , et al. A mosaic pattern of INI1/SMARCB1 protein expression distinguishes schwannomatosis and NF2-associated peripheral schwannomas from solitary peripheral schwannomas and NF2-associated vestibular schwannomas. Childs Nerv Syst 2017; 33 (06) 933-940
• 18 Ruggieri M, Iannetti P, Clementi M. , et al. Neurofibromatosis type 1 and infantile spasms. Childs Nerv Syst 2009; 25 (02) 211-216
• 19 Ruggieri M. Familial hypomelanosis of Ito: implications for genetic counselling. Am J Med Genet 2000; 95 (01) 82-84
• 20 Ruggieri M, Magro G, Ruggieri M, Polizzi A. Tumors and hypomelanosis of Ito. Arch Pathol Lab Med 2001; 125 (05) 599-601
• 21 Ruggieri M, Mastrangelo M, Spalice A. , et al. Bilateral (opercular and paracentral lobular) polymicrogyria and neurofibromatosis type 1. Am J Med Genet A 2011; 155A [phone]
• 22 Pavone P, Praticò AD, Ruggieri M, Falsaperla R. Hypomelanosis of Ito: a round on the frequency and type of epileptic complications. Neurol Sci 2015; 36 (07) 1173-1180
• 23 Papetti L, Tarani L, Nicita F. , et al. Macrocephaly-capillary malformation syndrome: description of a case and review of clinical diagnostic criteria. Brain Dev 2012; 34 (02) 143-147
• 24 Ruggieri M, Milone P, Pavone P. , et al. Nevus vascularis mixtus (cutaneous vascular twin nevi) associated with intracranial vascular malformation of the Dyke-Davidoff-Masson type in two patients. Am J Med Genet A 2012; 158A (11) 2870-2880
• 25 Ruggieri M, Polizzi A, Strano S. , et al. Mixed vascular nevus syndrome: a report of four new cases and a literature review. Quant Imaging Med Surg 2016; 6 (05) 515-524
• 26 Barbagallo M, Ruggieri M, Incorpora G. , et al. Infantile spasms in the setting of Sturge-Weber syndrome. Childs Nerv Syst 2009; 25 (01) 111-118
• 27 Pavone P, Falsaperla R, Rizzo R. , et al. Chromosome 2p15-p16.1 microduplication in a boy with congenital anomalies: is it a distinctive syndrome?. Eur J Med Genet 2018; 1769-7212 (17) 30072-300721
• 28 Ruggieri M, D'Arrigo G, Abbate M, Distefano A, Upadhyaya M. Multiple coronary artery aneurysms in a child with neurofibromatosis type 1. Eur J Pediatr 2000; 159 (07) 477-480
• 29 Ruggieri M, Polizzi A. Choroidal abnormalities and mental retardation in neurofibromatosis type 1. Lancet 2001; 357 (9252): 311-312
• 30 Ruggieri M, Pavone V, Tiné A. , et al. Ossifying fibroma of the skull in a patient with neurofibromatosis type 1. Case report. J Neurosurg 1996; 85 (05) 941-944
• 31 Ruggieri M, Pavone V, Polizzi A. , et al. Unusual form of recurrent giant cell granuloma of the mandible and lower extremities in a patient with neurofibromatosis type 1. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999; 87 (01) 67-72
• 32 Ruggieri M, Huson SM. The neurofibromatoses. An overview. Ital J Neurol Sci 1999; 20 (02) 89-108
• 33 Ruggieri M. Cutis tricolor: congenital hyper- and hypopigmented lesions in a background of normal skin with and without associated systemic features: further expansion of the phenotype. Eur J Pediatr 2000; 159 (10) 745-749
• 34 Ruggieri M, Pavone P, Polizzi A. , et al. Ophthalmological manifestations in segmental neurofibromatosis type 1. Br J Ophthalmol 2004; 88 (11) 1429-1433
• 35 Ruggieri M, Polizzi A. Segmental neurofibromatosis. J Neurosurg 2000; 93 (03) 530-532
• 36 Ruggieri M, Tigano G, Mazzone D, Tiné A, Pavone L. Involvement of the white matter in hypomelanosis of Ito (incontinentia pigmenti achromiens). Neurology 1996; 46 (02) 485-492
• 37 Ruggieri M. Mosaic (segmental) neurofibromatosis type 1 (NF1) and type 2 (NF2): no longer neurofibromatosis type 5 (NF5). Am J Med Genet 2001; 101 (02) 178-180
• 38 Ruggieri M, Praticò AD. Mosaic neurocutaneous disorders and their causes. Semin Pediatr Neurol 2015; 22 (04) 207-233
• 39 Ruggieri M, Rizzo R, Pavone P, Baieli S, Sorge G, Happle R. Temporal triangular alopecia in association with mental retardation and epilepsy in a mother and daughter. Arch Dermatol 2000; 136 (03) 426-427
• 40 Pavone P, Praticò AD, Gentile G. , et al. A neurocutaneous phenotype with paired hypo- and hyperpigmented macules, microcephaly and stunted growth as prominent features. Eur J Med Genet 2016; 59 (05) 283-289
• 41 Alfaro A, Torrelo A, Hernández A, Zambrano A, Happle R. Síndrome del nevo de Becker. Actas Dermosifiliogr 2007; 98 (09) 624-626
• 42 Ingordo V, Iannazzone SS, Cusano F, Naldi L. Dermoscopic features of congenital melanocytic nevus and Becker nevus in an adult male population: an analysis with a 10-fold magnification. Dermatology 2006; 212 (04) 354-360
• 43 Pektas SD, Akoglu G, Metin A, Adiyaman NS, Demirseren ME. Becker nevus syndrome presented with ipsilateral breast hypoplasia. Indian J Dermatol 2014; 59 (06) 634
• 44 Polizzi A, Pavone P, Ciancio E, La Rosa C, Sorge G, Ruggieri M. Hypertrichosis cubiti (hairy elbow syndrome): a clue to a malformation syndrome. J Pediatr Endocrinol Metab 2005; 18 (10) 1019-1025
• 45 Khatami A, Seradj MH, Gorouhi F, Firooz A, Dowlati Y. Giant bilateral Becker nevus: a rare presentation. Pediatr Dermatol 2008; 25 (01) 47-51
• 46 Bologna J, Jorizzo JL, Schafer JV. Dermatology. Vol. 2. 3rd ed. Philadelphia, PA: Elsevier; 2012
• 47 Micali G, Verzì AE, Lacarrubba F. Alternative Uses of Dermatoscopy In Daily Clinical Practice: An Update. J Am Acad Dermatol 2018; pii: S0190-9622(18)32143-1 . doi: 10.1016/j.jaad.2018.06.021
• 48 Ingordo V, Iannazzone SS, Cusano F, Naldi L. Dermoscopic features of congenital melanocytic nevus and Becker nevus in an adult male population: an analysis with a 10-fold magnification. Dermatology 2006; 212 (04) 354-360
• 49 Rasi A, Berenji AH, Tabaie SM. Hypertrichosis is not so prevalent in Becker's nevus: nevus: analysis of 47 cases. IRSN Dermatolol 2014; 201: 953747 . doi: 10.1155/2014/953747
• 50 Panizzon R, Brüngger H, Vogel A. Becker nevus. A clinico-histologic-electron microscopy study of 39 patients [article in German]. Hautarzt 1984; 35 (11) 578-584
• 51 Fegeler F, Schreiner H. Familiäres Vorkommen von systematisierten Pigmentnaevi mit circumscripter Sklerodermie im gleichen Hautsegment. Hautarzt 1954; 5 (06) 253-255
• 52 Rufli T. Melanosis Becker mit lokalisierter Sklerodermie. Dermatologica 1972; 145 (03) 222-229
• 53 Smolle J. Becker'sche Melanose und oberflächliche zirkumskripte Sklerodermie. Akt Dermatol. 1983; 9: 187-188
• 54 Downs AM, Mehta R, Lear JT, Peachey RD. Acne in a Becker's naevus: an androgen-mediated link?. Clin Exp Dermatol 1998; 23 (04) 191-192
• 55 Formigón M, Alsina MM, Mascaró JM, Rivera F. Becker's nevus and ipsilateral breast hypoplasia--androgen-receptor study in two patients. Arch Dermatol 1992; 128 (07) 992-993
• 56 Nirdé P, Dereure O, Belon C, Lumbroso S, Guilhou JJ, Sultan C. The association of Becker nevus with hypersensitivity to androgens. Arch Dermatol 1999; 135 (02) 212-214
• 57 Sheng P, Cheng YL, Cai CC. , et al. Clinicopathological features and immunohistochemical alterations of keratinocyte proliferation, melanocyte density, smooth muscle hyperplasia and nerve fiber distribution in Becker's nevus. Ann Dermatol 2016; 28 (06) 697-703
• 58 Patel P, Malik K, Khachemoune A. Sebaceus and Becker's nevus: overview of their presentation, pathogenesis, associations, and treatment. Am J Clin Dermatol 2015; 16 (03) 197-204
• 59 Rongbiao LU, Han MA, Chun LU, Wei LAI. Beckers nevus syndrome with bilateral skin involvement. Case report. Dermatologia Sinica 2014; 32: 107-109
• 60 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; 30 (04) 655-657
• 61 Maessen-Visch MB, Hulsmans RFHJ, Hulsmans FJH, Neumann HAM. Melanosis naeviformis of Becker and scoliosis: a coincidence?. Acta Derm Venereol 1997; 77 (02) 135-136
• 62 Ruggieri M, Pavone V, De Luca D, Franzò A, Tiné A, Pavone L. Congenital bone malformations in patients with neurofibromatosis type 1 (Nf1). J Pediatr Orthop 1999; 19 (03) 301-305
• 63 Ruggieri M, Pavone V, Polizzi A. , et al. Tuberculosis of the ankle in childhood: clinical, roentgenographic and computed tomography findings. Clin Pediatr (Phila) 1997; 36 (09) 529-534
• 64 Sorge G, Ruggieri M, Polizzi A, Scuderi A, Di Pietro M. SHORT syndrome: a new case with probable autosomal dominant inheritance. Am J Med Genet 1996; 61 (02) 178-181
• 65 Pavone P, Spalice A, Polizzi A, Parisi P, Ruggieri M. Ohtahara syndrome with emphasis on recent genetic discovery. Brain Dev 2012; 34 (06) 459-468
• 66 Vincent A, Jacobson L, Plested P. , et al. Antibodies affecting ion channel function in acquired neuromyotonia, in seropositive and seronegative myasthenia gravis, and in antibody-mediated arthrogryposis multiplex congenita. Ann N Y Acad Sci 1998; 841 (841) 482-496
• 67 Polizzi A, Pavone P, Iannetti P, Manfré L, Ruggieri M. Septo-optic dysplasia complex: a heterogeneous malformation syndrome. Pediatr Neurol 2006; 34 (01) 66-71
• 68 Iannetti P, Parisi P, Spalice A, Ruggieri M, Zara F. Addition of verapamil in the treatment of severe myoclonic epilepsy in infancy. Epilepsy Res 2009; 85 (01) 89-95
• 69 Polizzi A, Finocchiaro M, Parano E, Pavone P, Musumeci S, Polizzi A. Recurrent peripheral neuropathy in a girl with celiac disease. J Neurol Neurosurg Psychiatry 2000; 68 (01) 104-105
• 70 Salpietro V, Polizzi A, Bertè LF. , et al. Idiopathic intracranial hypertension: a unifying neuroendocrine hypothesis through the adrenal-brain axis. Neuroendocrinol Lett 2012; 33 (06) 569-573
• 71 Salpietro V, Polizzi A, Di Rosa G. , et al. Adrenal disorders and the paediatric brain: pathophysiological considerations and clinical implications. Int J Endocrinol 2014; 2014: 282489
• 72 Matricardi S, Spalice A, Salpietro V. , et al. Epilepsy in the setting of full trisomy 18: a multicenter study on 18 affected children with and without structural brain abnormalities. Am J Med Genet C Semin Med Genet 2016; 172 (03) 288-295
• 73 Salpietro V, Mankad K, Kinali M. , et al. Pediatric idiopathic intracranial hypertension and the underlying endocrine-metabolic dysfunction: a pilot study. J Pediatr Endocrinol Metab 2014; 27 (1–2): 107-115
• 74 Lionetti E, Francavilla R, Maiuri L. , et al. Headache in pediatric patients with celiac disease and its prevalence as a diagnostic clue. J Pediatr Gastroenterol Nutr 2009; 49 (02) 202-207
• 75 O'Connor KC, Lopez-Amaya C, Gagne D. , et al. Anti-myelin antibodies modulate clinical expression of childhood multiple sclerosis. J Neuroimmunol 2010; 223 (1-2): 92-99
• 76 Polizzi A, Coghill S, McShane MA, Squier W. Acute ataxia complicating Langherans cell histiocytosis. Arch Dis Child 2002; 86 (02) 130-131
• 77 Polizzi A, Pavone P, Parano E, Incorpora G, Ruggieri M. Lack of progression of brain atrophy in Aicardi-Goutières syndrome. Pediatr Neurol 2001; 24 (04) 300-302
• 78 Ruggieri M, McShane MA. Parental view of epilepsy in Angelman syndrome: a questionnaire study. Arch Dis Child 1998; 79 (05) 423-426
• 79 Sathyanarayana BD, Basavaraj GB, Nischal KC, Swaroop MR, Umashankar NP, Suchetha S. Becker's nevus syndrome. Indian J Dermatol 2014; 59: 421
• 80 Brancati F, Travaglini L, Zablocka D. , et al; International JSRD Study Group. RPGRIP1L mutations are mainly associated with the cerebello-renal phenotype of Joubert syndrome-related disorders. Clin Genet 2008; 74 (02) 164-170
• 81 Pavone P, Nigro F, Falsaperla R. , et al. Hemihydranencephaly: living with half brain dysfunction. Ital J Pediatr 2013; 39: 3
• 82 Pavone P, Praticò AD, Vitaliti G. , et al. Hydranencephaly: cerebral spinal fluid instead of cerebral mantles. Ital J Pediatr 2014; 40: 79
• 83 Pavone P, Praticò AD, Rizzo R. , et al. A clinical review on megalencephaly: a large brain as a possible sign of cerebral impairment. Medicine (Baltimore) 2017; 96 (26) e6814
• 84 Pavone P, Falsaperla R, Ruggieri M. , et al. Clinical course of NMDAr encephalitis and effectiveness of cyclosphosphamide treatment. J Pediatr Neurol 2017; 15: 84-89
• 85 Praticò AD, Falsaperla R, Ruggieri M, Corsello G, Pavone P. Prognostic challenges of SCN1A genetic mutations: report on two children with mild features. J Pediatr Neurol 2016; 14: 82-88
• 86 Distefano G, Praticò AD. Actualities on molecular pathogenesis and repairing processes of cerebral damage in perinatal hypoxic-ischemic encephalopathy. Ital J Pediatr 2010; 36: 63
• 87 Pavone P, Briuglia S, Falsaperla R. , et al. Wide spectrum of congenital anomalies including choanal atresia, malformed extremities, and brain and spinal malformations in a girl with a de novo 5.6-Mb deletion of 13q12.11-13q12.13. Am J Med Genet A 2014; 164A [phone]
• 88 Ruggieri M, Iannetti P, Pavone L. Delineation of a newly recognized neurocutaneous malformation syndrome with “cutis tricolor”. Am J Med Genet A 2003; 120A [phone]
• 89 Ruggieri M, Iannetti F, Polizzi A. , et al. Cataracts in the setting of a newly recognised neurocutaneous malformation syndrome with cutis tricolor. Br J Ophthalmol 2009; 93: 175-176
• 90 Ruggieri M, Roggini M, Kennerknecht I, Polizzi A, Distefano A, Pavone V. Spectrum of skeletal abnormalities in a complex malformation syndrome with “cutis tricolor” (Ruggieri-Happle syndrome). Acta Paediatr 2011; 100 (01) 121-127
• 91 Nicita F, Spalice A, Roggini M. , et al. Complex malformation (Ruggieri-Happle) phenotype with “cutis tricolor” in a 10-year-old girl. Brain Dev 2012; 34 (10) 869-872
• 92 Ruggieri M, Polizzi A, Schepis C. , et al. Cutis tricolor: a literature review and report of five new cases. Quant Imaging Med Surg 2016; 6 (05) 525-534
• 93 Lionetti E, Pavone P, Kennerknecht I. , et al. Neurological manifestations in individuals with pure cutaneous or syndromic (Ruggieri-Happle syndrome) phenotypes with “cutis tricolor”: a study of 14 cases. Neuropediatrics 2010; 41 (02) 60-65
• 94 Wagner Jr RF, Grande DJ, Bhawan J, Hellerstein MK, Longcope C. Unilateral dermatomal superficial telangiectasia overlapping Becker's melanosis. Int J Dermatol 1989; 28 (09) 595-596
• 95 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; 59 (05) 834-838
• 96 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; 14 (5 Pt 2): 905-907
• 97 Happle R. Mosaicism in human skin. Understanding the patterns and mechanisms. Arch Dermatol 1993; 129 (11) 1460-1470
• 98 Baeta IG, Viotti CV, Pereira AC, Costa Júnior SR, Bittencourt FV. Becker's nevus syndrome: case report. An Bras Dermatol 2010; 85 (05) 713-716
• 99 Happle R. What is paradominant inheritance?. J Med Genet 2009; 46 (09) 648
• 100 Jeon IK, On HR, Kim SC. Quality of life and economic burden in recessive dystrophic epidermolysis bullosa. Ann Dermatol 2016; 28 (01) 6-14
• 101 Losee JE, Serletti JM, Pennino RP. Epidermal nevus syndrome: a review and case report. Ann Plast Surg 1999; 43 (02) 211-214
• 102 Happle R. Epidermal nevus syndromes. Semin Dermatol 1995; 14 (02) 111-121
• 103 Thomas VD, Snavely NR, Lee KK, Swanson NA. Benignan epithelial tumors, hamartomas and hyperplasias. In: Wolff K. , ed. Fitzpatrick's Dermatology in General Medicine. 8th ed. New York, NY: McGraw-Hill; 2012: 1319-1335
• 104 Alfadley A, Hainau B, Al Robaee A, Banka N. Becker's melanosis: a report of 12 cases with atypical presentation. Int J Dermatol 2005; 44 (01) 20-24
• 105 Kim YJ, Han JH, Kang HY, Lee ES, Kim YC. Androgen receptor overexpression in Becker nevus: histopathologic and immunohistochemical analysis. J Cutan Pathol 2008; 35 (12) 1121-1126
• 106 Burgreen BL, Ackerman AB. Acneform lesions in Becker's nevus. Cutis 1978; 21 (05) 617-619
• 107 Agrawal S, Garg VK, Sah SP, Agarwalla A. Acne in Becker's nevus. Int J Dermatol 2001; 40 (09) 583-585
• 108 Person JR, Longcope C. Becker's nevus: an androgen-mediated hyperplasia with increased androgen receptors. J Am Acad Dermatol 1984; 10 (2 Pt 1): 235-238
• 109 Downs AM, Mehta R, Lear JT, Peachey RD. Acne in a Becker's naevus: an androgen-mediated link?. Clin Exp Dermatol 1998; 23 (04) 191-192
• 110 Juhl M, Pappo E, Bain M. Acne isolated within a Becker nevus of a 14 year-old girl. Dermatol Online J 2015; 21 (08) 13030/qt4jb09198
• 111 Lockshin BN, Brogan B, Billings S, Billings S. Eczematous dermatitis and prurigo nodularis confined to a Becker's nevus. Int J Dermatol 2006; 45 (12) 1465-1466
• 112 Terheyden P, Hornschuh B, Karl S, Becker JC, Bröcker EB. Lichen planus associated with Becker's nevus. J Am Acad Dermatol 1998; 38 (5 Pt 1): 770-772
• 113 Puri S, Nanda S, Grover C, Batra VV, Garg VK, Reddy BS. Congenital becker nevus with lichen planus. Pediatr Dermatol 2005; 22 (04) 328-330
• 114 Gupta S, Gupta S, Aggarwal K, Jain VK. Becker nevus with vitiligo and lichen planus: cocktail of dermatoses. N Am J Med Sci 2010; 2 (07) 333-335
• 115 Wright RC. Another association with Becker's nevus. Arch Dermatol 1979; 115 (09) 1035
• 116 Singal A, Bhattacharya SN, Kumar S, Baruah MC. Hypopigmented pityriasis versicolor on Becker's naevus : hope for new method of treatment?. Indian J Dermatol Venereol Leprol 1998; 64 (03) 137-138
• 117 Bhogal CS, Singal A, Baruah MC. Hypopigmented pityriasis versicolor developing on a pre-existing Becker's Naevus. Indian J Dermatol Venereol Leprol 2002; 68 (01) 43-44
• 118 Weinberg JM, Scheinfeld N, Tishler HR. Granuloma annulare restricted to Becker's naevus. Br J Dermatol 2004; 151 (01) 245-246
• 119 Do JE, Kim YJ, Kang HY. Hypohidrosis colocalized with Becker's naevus. Br J Dermatol 2007; 156 (04) 766-767
• 120 Criscione V, Telang GHT. Becker nevus with ichthyotic features. Arch Dermatol 2010; 146 (05) 575-577
• 121 Honda M, Suzuki T, Kudoh K, Tagami H. Bowen's disease developing within a Becker's melanosis (Becker's naevus). Br J Dermatol 1997; 137 (04) 659-661
• 122 Patrizi A, Medri M, Neri I, Fanti PA. Becker naevus associated with basal cell carcinoma, melanocytic naevus and smooth-muscle hamartoma. J Eur Acad Dermatol Venereol 2007; 21 (01) 130-132
• 123 Buder K, Wendel AM, Cerroni L, Goebeler M, Kerstan A. A case of lymphomatoid papulosis limited to Becker's melanosis. Dermatology 2013; 226 (02) 124-127
• 124 Thappa DM, Garg BR, Prasad RR, Ratnakar C. Multiple leiomyoma cutis associated with Becker's nevus. J Dermatol 1996; 23 (10) 719-720
• 125 Park SBM, Song BH, Park EJ, Kwon IH, Kim KH, Kim KJ. A case of Becker's nevus with osteoma cutis. Ann Dermatol 2011; 23 (Suppl. 02) S247-S249
• 126 Sciallis GF, Sciallis AP. Becker nevus with an underlying desmoid tumor: a case report and review including Mayo Clinic's experience. Arch Dermatol 2010; 146 (12) 1408-1412
• 127 Waelchli R, Williams J, Cole T. , et al. Growth and hormone profiling in children with congenital melanocytic naevi. Br J Dermatol 2015; 173 (06) 1471-1478
• 128 Patel KR, Chernock R, Lewis Jr JS, Raptis CA, Al Gilani M, Dehner LP. Lipomatous congenital melanocytic nevus presenting as a neck mass in a young adult. Head Neck Pathol 2013; 7 (04) 404-408
• 129 Pavone P, Rizzo R, Conti I. , et al. Primary headaches in children: clinical findings on the association with other conditions. Int J Immunopathol Pharmacol 2012; 25 (04) 1083-1091
• 130 Kienast AK, Hoeger PH. Cutis marmorata telangiectatica congenita: a prospective study of 27 cases and review of the literature with proposal of diagnostic criteria. Clin Exp Dermatol 2009; 34 (03) 319-323
• 131 Castori M, Rinaldi R, Angelo C, Zambruno G, Grammatico P, Happle R. Phacomatosis cesioflammea with unilateral lipohypoplasia. Am J Med Genet A 2008; 146A [phone]
• 132 Thomas AC, Zeng Z, Rivière JB. , et al. Mosaic activating mutations in GNA11 and GNAQ are associated with phakomatosis pigmentovascularis and extensive dermal melanocytosis. J Invest Dermatol 2016; 136 (04) 770-778
• 133 Cohen Jr MM. Proteus syndrome review: molecular, clinical, and pathologic features. Clin Genet 2014; 85 (02) 111-119
• 134 Keppler-Noreuil KM, Sapp JC, Lindhurst MJ. , et al. Clinical delineation and natural history of the PIK3CA-related overgrowth spectrum. Am J Med Genet A 2014; 164A [phone]
• 135 Happle R. The categories of cutaneous mosaicism: a proposed classification. Am J Med Genet A 2016; 170A [phone]
• 136 Schmidt CS, Bentz ML. Congenital smooth muscle hamartoma: the importance of differentiation from melanocytic nevi. J Craniofac Surg 2005; 16 (05) 926-929
• 137 Becker SW, Reuter MJ. A familial pigmentary anomaly. Arch Dermatol 1939; 40: 987-998
• 138 Bleehen SS, Ebling FJC, Champion CH. Disorders of skin colours. In: Champion RH, Burton JL, Ebling FJG. , eds. Rook/Wilkinson/Ebling Textbook of Dermatology. 5th ed. Oxford: Blackwell Scientific Publications; 1992: 1561-1622
• 139 Pektas SD, Akoglu G, Metin A, Adiyaman NS, Demirseren ME. Becker nevus syndrome presented with ipsilateral breast hypoplasia. Indian J Dermatol 2014; 59 (06) 634
• 140 Matelitsa A, Rohrer T, Arndt KA. Laser and light therapy for cutaneous hyperpigmentation. UpToDate. 2017 . Available at: https://www.uptodate.com/contents/laser-and-light-therapy-for-cutaneous-hyperpigmentation . Accessed December 18, 2017
• 141 Nanni CA, Alster TS. Treatment of a Becker's nevus using a 694-nm long-pulsed ruby laser. Dermatol Surg 1998; 24 (09) 1032-1034
• 142 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; 35 (07) 1105-1108
• 143 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; 29 (01) 191-193
• 144 Sharma M, Kansal NK, Gautam RK. A case of Becker's nevus with pityriasis versicolor. J Eur Acad Dermatol Venereol 2014; 28 (12) 1827-1828
• 145 Tse Y, Levine VJ, McClain SA, Ashinoff R. The removal of cutaneous pigmented lesions with the Q-switched ruby laser and the Q-switched neodymium: yttrium-aluminum-garnet laser. A comparative study. J Dermatol Surg Oncol 1994; 20 (12) 795-800
• 146 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 (04) 338-343
• 147 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; 152 (02) 308-313
• 148 Meesters AA, Wind BS, Kroon MW. , et al. Ablative fractional laser therapy as treatment for Becker nevus: a randomized controlled pilot study. J Am Acad Dermatol 2011; 65 (06) 1173-1179
• 149 Glaich AS, Goldberg LH, Dai T, Kunishige JH, Friedman PM. Fractional resurfacing: a new therapeutic modality for Becker's nevus. Arch Dermatol 2007; 143 (12) 1488-1490
• 150 Narins RS, Brandt F, Leyden J, Lorenc ZP, Rubin M, Smith S. A randomized, double-blind, multicenter comparison of the efficacy and tolerability of Restylane versus Zyplast for the correction of nasolabial folds. Dermatol Surg 2003; 29 (06) 588-595
• 151 Hoon Jung J, Chan Kim Y, Joon Park H, Woo Cinn Y. Becker's nevus with ipsilateral breast hypoplasia: improvement with spironolactone. J Dermatol 2003; 30 (02) 154-156
• 152 Taheri A, Mansoori P, Sandoval LF, Feldman SR. Treatment of Becker nevus with topical flutamide. J Am Acad Dermatol 2013; 69 (03) e147-e148