Becker Nevus in Focus: Clinical and Histopathological Insights with a Pattern of Epidermal Pigmentation Mimicking Regional Fitzpatrick Type VI Skin Implant

Abstract

Background Becker nevus is an uncommon form of acquired cutaneous malformation marked by a unilateral, pigmented patch frequently accompanied by an excessive hair growth later on. It usually observed on the upper chest, scapular region, and proximal portions of the arms. Objective To redefine the clinical and histopathological assessment of Becker nevus. Methods This descriptive case study included patients of all ages, both sexes, clinically and histopathologically diagnosed with Becker nevus. A careful physical examination was conducted. Wood's light examination, as well as skin biopsy by a 5-mm punch was obtained. Results The higher age of onset was during the second decade of life. A positive family history was reported in 7.6% of cases, while consanguinity was present in 15.4% of patients, and the congenital presentation was detected in 3.8% of cases. The hypertrichosis was presented in 63.5% of cases. The histopathology showed hyperkeratosis and acanthosis, while the melanin store was only epidermal while the dermal element was almost lacking. Conclusion Becker nevus is a relatively frequent among the Iraqi population. It could be considered as localized Fitzpatrick type VI skin implanted in Fitzpatrick type II-IV person with increased epidermal melanin storage. Eastern and Western populations showed comparable findings, except for the higher frequency of consanguinity and positive family history.