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Becker nevus in Adult
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Becker nevus in Adult

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Contributors: Stephanie Diamantis MD, Lynn McKinley-Grant MD, Aída Lugo-Somolinos MD, Lowell A. Goldsmith MD, MPH
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A Becker nevus (Becker melanosis) is an acquired, benign, melanocytic epidermal proliferation of adolescence. It typically presents as a large, hyperpigmented patch with increased hair growth on the upper trunk in men. This lesion is not uncommon and is found in all ethnicities. Lesions are usually present before puberty but often have increased coarse hair growth and a slightly raised texture during adolescence due to androgen stimulation. Rarely, there can be associated hypoplasia of the underlying tissues (eg, breast hypoplasia, pectoralis hypoplasia, or limb hypoplasia). Most Becker nevi have no associated abnormalities.

Treatment is only required in rare cases for severe cosmetic or psychosocial reasons. Other rare associated findings include acne, acanthosis nigricans, spina bifida, scoliosis, pectus carinatum, accessory scrotum, lipoatrophy, and congenital adrenal hyperplasia. A few cases of melanoma in association with a Becker nevus have been reported.

For more information, see OMIM.


D22.9 – Melanocytic nevi, unspecified

5387003 – Becker's nevus

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Differential Diagnosis & Pitfalls

  • Giant congenital nevi are darker and have a distorted hair pattern, often with coarse hair, unlike the regular but exuberant hair in a Becker nevus.
  • Epidermal nevi frequently have more epidermal changes and lie in a dermatomal distribution.
  • Tinea versicolor presents with small, faintly hyper- or hypopigmented, scaly patches over the back and trunk.
  • Ephelides (freckles) are small, pigmented, photodistributed macules.
  • Lentigos are small, nonpalpable, pigmented macules and patches.
  • Giant café au lait macules can clinically resemble a Becker nevus in preadolescent patients but can usually be distinguished later by the development of hypertrichosis and epidermal / dermal changes in a Becker nevus.

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Last Updated: 11/01/2018
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Becker nevus in Adult
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Becker nevus : Brown color, Hyperpigmented patch, Hypertrichosis, Shoulder, Unilateral, Upper back
Clinical image of Becker nevus
A large, brown patch with associated hypertrichosis and outlying smaller patches on the back.
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