Acne in Becker's nevus

Abstract

An 18‐year‐old man presented with a progressively enlarging, asymptomatic, well‐demarcated, irregular, hyperpigmented patch, 13 cm × 11 cm, on the anterior aspect of the chest below the left clavicular region, with a few small macules at the periphery, of 2 years duration. After 18 months, multiple, discrete, erythematous papules and comedones developed over the patch (Fig. 1). A few melanocytic nevi were present in and around the patch. A clinical diagnosis of Becker's nevus with acne vulgaris was made. A skin biopsy from the patch showed acanthosis, elongated rete ridges, increased pigmentation in the basal layer, and a mild perivascular lymphocytic infiltrate in the upper and lower dermis with few melanophages in the dermis. Histopathology of the comedone revealed slight acanthosis, irregular elongation of the rete ridges, and hyperpigmentation of the basal layer of the epidermis. Multiple melanophages were seen in the upper dermis. In the mid‐dermis, a ruptured closed comedone was seen. The follicular lumen contained a plug of loosely arranged keratinized cells, sebaceous material, and bacterial colonies. Aggregates of neutrophils were found at the site of rupture of the follicular wall. There was a mild perivascular lymphocytic infiltrate in the upper and lower dermis (Fig. 2). These features confirmed the diagnosis of Becker's nevus with acne vulgaris. The acne was treated with 0.05% tretinoin and 2% erythromycin creams. After 2 months of treatment, all the acne lesions subsided. On further follow‐up, the patient had relapse of the acne lesions over the patch with the discontinuation of treatment. A few new lesions also appeared on the face. The treatment was restarted, but the patient was lost to follow‐up. 1 Multiple, discrete, erythematous papules and comedones over Becker's nevus with a few melanocytic nevi in and around the lesion 2 Slight acanthosis, irregular elongation of the rete ridges, and hyperpigmentation of the basal layer of the epidermis, multiple melanophages in the upper dermis, and a ruptured closed comedone in the mid‐dermis (hematoxylin and eosin, × 40)

Disorders of pigmentation

“…547 Actinic lichen planus is another association, possibly fortuitous. 586,587 Diseases reported to have developed in a Becker's nevus include eczematous dermatitis and prurigo nodularis, 588 hypohidrosis, 589 acneiform lesions, 569,590,591 lichen planus, 571 localized scleroderma, 564 and a basal cell carcinoma combined with a melanocytic nevus and a smooth muscle hamartoma. 542 Familial occurrence involving three members of the same family has been reported.…”

Genç Erkeklerde Becker Nevüs Prevalansı

“…12 . Ayrıca literatürde BN ve akneiform lezyonların birlikte olduğu olguların da bildirilmiş olması BN'ün androjen reseptör aracılığı ile oluşabileceğini desteklemektedir, fakat yayın sayısı oldukça azdır [13][14][15] . Bizim olgularımızda BN ile birlikte artmış akneiform lezyon birlikteliği saptanmadı.…”

Segmental Acne versus Mosaic Conditions with Acne Lesions

“…We identified 10 cases of acne lesions confined to a Becker nevus (8 males, 2 females; 8 whites, 2 Indians; average age 19.4 years, average duration of the rash 3.7 years) and were therefore arranged in a segmental, block-like pattern [13,14,15,16,17,18,19,20]. Nine nevi involved the chest, one the arm; 5 were on the left side, 4 on the right side, 1 unknown.…”

“…Nine nevi involved the chest, one the arm; 5 were on the left side, 4 on the right side, 1 unknown. Four cases also showed typical acne [14,15,18] and 2 breast hypoplasia [19,20]. In addition, a case of nonorganoid keratinocytic epidermal nevus with superimposed acne lesions on the left upper trunk and arm of a 13-year-old boy has been recently reported [21].…”