10.5826/dpc.1202a74
&nbsp;



text/xml
2160-9381
1894
en
Tao Chen
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
Dermoscopy
Follicular Becker's nevus: an unusual clinical and dermoscopic manifestation
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Research Letter
2022-05-02
2021-07-18
2022-05-02
2022-05-24
e2022074
Dermatol Pract Concept
&nbsp;



Tao Chen
2022/05/02
10.5826/dpc.1202a74
e2022074
Department of Dermatovenereology, Chengdu Second People’s Hospital, Chengdu, Sichuan, China.
2160-9381
Dermoscopy
en
e2022074
Manchanda Y, Khaitan BK, Ramam M, Das S, Al-Mutairi N. Follicular Becker's Nevus: A New Clinical Variant. Indian J Dermatol. 2020;65(2):130-132. DOI: 10.4103/ijd.IJD_476_18. PMID: 32180599. PMCID: PMC7059461.
Follicular Becker's nevus: an unusual clinical and dermoscopic manifestation
https://dpcj.org/index.php/dpc/article/download/1894/1573
           Follicular Becker Nevus: an Unusual Clinical
                 and Dermoscopic Manifestation
                       Li-wen Zhang1, Xue Shen1, Lei Xu1, Hai-peng Shi2, Tao Chen1


1 Department of Dermatovenereology, Chengdu Second People’s Hospital, Chengdu, Sichuan, China
2 Department of Pathology, Chengdu Second People’s Hospital, Chengdu, Sichuan, China



Key words: Becker nevus, follicular, dermoscopy, papule
Citation: Zhang L, Shen X, Xu L, Shi H, Chen T. Follicular Becker’s nevus: an unusual clinical and dermoscopic manifestation.
Dermatol Pract Concept. 2022;12(2):e2022074. DOI: https://doi.org/10.5826/dpc.1202a74
Accepted: September 8, 2021; Published: April 2022
Copyright: ©2022 Zhang et al. This is an open-access article distributed under the terms of the Creative Commons Attribution-
NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use,
distribution, and reproduction in any medium, provided the original authors and source are credited.
Funding: None.
Competing interests: None.
Authorship: All authors have contributed significantly to this publication.
Corresponding author: Tao Chen, Department of Dermatovenereology, Chengdu Second People’s Hospital, 165 Caoshi Street,
Chengdu 610017, Sichuan, China. E-mail: 13980427003@163.com




Introduction                                                             Discussion
Becker nevus (BN) is characterized by a unilateral, hairy,               BN, also called pigmented hairy epidermal nevus, is char-
pigmented macule usually involving the chest or scapular re-             acterized by a unilateral, hairy, pigmented macule usually
gion. We hereby reported a specific case of follicular BN pre-           involving the upper chest or the scapular region, a few cases
senting follicular macules and maculopapules, and described              present multiple or bilateral. The pathogenesis is still unclear.
its dermoscopic manifestation.                                           The plausible explanations for BN include mosaicism and
                                                                         an androgen-dependent lesion [1]. BN has male predilection,

Case Presentation                                                        with a 2:1 to 5:1 predominance of men over women [1].
                                                                         BN commonly appears during adolescence and some cases
A 20-year-old female presented with a 12-year history of                 are congenital. The lesions usually present as an asymptom-
multiple clustered asymptomatic brown macules and maculo-                atic well-demarcated, irregular, brown macule with a geo-
papules affecting the inside of the left upper arm (Figure 1A).          graphic or block-like configuration. However, Manchanda
The pigmented lesions gradually increased in the initial                 et al first reported an unusual clinical manifestation of BN
phase and then stabilized. No other accompanied systemic                 in 2020, which presented follicular lesions [2]. They specu-
abnormality was found. Familiar and medical histories were               lated that some BN might begin from perifollicular lesions
unremarkable. The dermoscopy revealed multiple brown                     and follicular epithelium might hold a significant role in the
round perifollicular macules with thicker hairs in the folli-            etiopathogenesis. The mechanism of follicular BN and the
cles (Figure 1B). The histopathological examination showed               pathogenesis of BN remain to be further studied.
hyperkeratosis, acanthosis, and darkly pigmented basal cell                   BN usually do not require treatment, and some potential
layer (Figure 1C). A diagnosis of follicular BN was made.                therapeutic options were taken due to cosmetic requirement,



Research Letter | Dermatol Pract Concept. 2022;12(2):e2022074                                                                           1
                                                                Figure 1. (A) Multiple clustered brown follicular macules and
                                                                maculopapules affecting the inside of the left upper arm. (B) The
                                                                dermoscopy revealed multiple brown round perifollicular macules
                                                                with thicker hairs in the follicles. (C) The histopathology showed
                                                                hyperkeratosis, acanthosis, and darkly pigmented basal cell layer
                                                                (H&E staining; ×200 magnification).



including electrolysis, waxing, makeup, laser treatment, and    References
topical therapy. Currently, no consensus has yet been reached
in the literature regarding which treatment is preferred and    1. Danarti R, Konig A, Salhi A, Bittar M, Happle R. Becker’s nevus
                                                                   syndrome revisited. J Am Acad Dermatol. 2004;51(6):965-969.
success with each treatment varies widely.
                                                                   DOI: 10.1016/j.jaad.2004.06.036. PMID: 15583590.
                                                                2. Manchanda Y, Khaitan BK, Ramam M, Das S, Al-Mutairi N.

Conclusions                                                        Follicular Becker’s Nevus: A New Clinical Variant. Indian J
                                                                   Dermatol. 2020;65(2):130-132. DOI: 10.4103/ijd.IJD_476_18.
Follicular BN is an unusual clinical variant. The dermatolo-       PMID: 32180599. PMCID: PMC7059461.

gist should be aware of the unusual clinical manifestation of
BN, which could permit to quickly solve the clinical doubts
and reassure the patient.




2                                                                  Research Letter | Dermatol Pract Concept. 2022;12(2):e2022049
