Becker’s naevus

Patient Information Leaflet
Link: Becker's naevus

https://pcds.org.uk/patient-info-leaflets/beckers-naevus

Becker’s naevus is a relatively common, benign epidermal naevus occurring mostly in males. 

This chapter is set out as follows: 

• It is mainly a sporadic finding, affecting approximately 0.5% of young men
• It is caused by an overgrowth of the epidermis and hair follicles
• It has been suggested that local androgen hypersensitivity is the major aetiological factor

• Mainly presents in young adults
• It is five times more frequent in males compared to females
• There is often a preceding history of sunburn

Distribution

• Predominantly the shoulder, anterior chest and scapular region
• Lesions have occasionally been reported at other sites

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 pigmentation is often quite pale but becomes 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
• Acne or, rarely, eczema can sometimes be present in a Becker’s naevus

Non-cutaneous features

• Becker’s naevus is usually an isolated phenomenon, however non-cutaneous abnormalities have been associated such as the underdevelopment of underlying structures or other tissues eg unilateral hypoplasia of the breast in females or the pectoralis major muscle, which collectively are referred to as the Becker's naevus syndrome

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• 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, although physical methods of hair removal may be of benefit and are not harmful
  • Various types of laser therapy has been used - overall, excess hair responds better than the colour