Abstract
Although the Becker nevus syndrome (BNS) is primarily defined as a Becker nevus (BN) in association with ipsilateral breast hypoplasia or musculoskeletal malformation, there are case reports about various associated malformations. The purpose of this study was to identify and analyze the common manifestations of the BNS. We conducted a systematic literature research about BNS and reviewed all available literature. In order to get an overview of the clinical manifestation, we analyzed all case reports by descriptive statistics. The most common manifestation of a BNS is breast hypoplasia, followed by musculoskeletal malformation and scoliosis. The regional correspondance between the skin manifestation and the malformation was strong for breast hypoplasia, musculoskeletal malformation, maxillofacial dysplasia, and lipodystrophy. Not all of the reported malformations are likely to be a manifestation of the BNS. By far, the most commonly described malformation is ipsilateral breast hypoplasia. Therefore, we would like to enhance the awareness of this syndrome among plastic surgeons.
Level of Evidence: Not ratable.
Similar content being viewed by others
References
Becker SW (1949) Concurrent melanosis and hypertrichosis in distribution of nevus unius lateris. Arch Dermatol Syphilol 60(2):155–160
Haneke E (1979) The dermal component in melanosis naeviformis Becker. J Cutan Pathol 6(1):53–58
Happle R, Koopman RJ (1997) Becker nevus syndrome. Am J Med Genet 68(3):357–361
Happle R (1995) Epidermal nevus syndromes. Semin Dermatol 14(2):111–121
Patrizi A, Medri M, Raone B, Bianchi F, Aprile S, Neri I (2012) Clinical characteristics of Becker’s nevus in children: report of 118 cases from Italy. Pediatr Dermatol 29(5):571–574
Danarti R, Konig A, Salhi A, Bittar M, Happle R (2004) Becker’s nevus syndrome revisited. J Am Acad Dermatol 51(6):965–969
Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 6(7):e1000097
Happle R (2010) The group of epidermal nevus syndromes part I. Well defined phenotypes. J Am Acad Dermatol 63(1):1–22; 23-24
Ingordo V, Gentile C, Iannazzone SS, Cusano F, Naldi L (2007) The ‘EpiEnlist’ project: a dermo-epidemiologic study on a representative sample of young Italian males. Prevalence of selected pigmentary lesions. J Eur Acad Dermatol Venereol: JEADV 21(8):1091–1096
Tymen R, Forestier JF, Boutet B, Colomb D (1981) Late Becker’s nevus. One hundred cases (author’s transl). Ann Dermatol Venereol 108(1):41–46
Sugarman JL (2007) Epidermal nevus syndromes. Semin Cutan Med Surg 26(4):221–230
Person JR, Longcope C (1984) Becker’s nevus: an androgen-mediated hyperplasia with increased androgen receptors. J Am Acad Dermatol 10(2 I):235–238
Formigon M, Alsina MM, Mascaro JM, Rivera F (1992) Becker’s nevus and ipsilateral breast hypoplasia androgen-receptor study in two patients. Arch Dermatol 128(7):992–993
Pektas SD, Akoglu G, Metin A, Adiyaman NS, Demirseren ME (2014) Becker nevus syndrome presented with ipsilateral breast hypoplasia. Ind J Dermatol 59(6):634
Rongbiao LU, Han MA, Chun LU, Wei LAI (2014) Becker’s nevus syndrome with bilateral skin involvement. Dermatol Sin 32(2):107–109
Schneider ME, Draths R, Fritsche E, Hug U (2014) The interesting case: unilateral hypoplasia of the breast in Becker nevus syndrome. Handchir Mikrochir Plast Chir 46(4):266–267
Namkoong S, Kim JY, Gye J, Chung J, Hong SP, Park BC et al (2012) Pigmented epithelioid melanocytoma developed in a patient with Becker nevus syndrome. J Dermatol 39(9):811–812
Patrizi AL, Di Lernia V (1989) Becker’s melanosis and associated abnormalities. Pediatr Dermatol 6(3):259
Steiner D, de Morais e Silva FA, ACAF P, Bialeski N, Feola C, CAB B (2011) Do you know this syndrome? An Bras Dermatol 86(1):165–166
Al-Niaimi F, Cooper S, Lyon CC (2011) Increased androgen receptor presence in breast hypoplasia associated with congenital linear Becker’s naevus with spontaneous breast enlargement during pregnancy. Br J Dermatol 165:16
Delano S, Deng A, Hay B, Gray C, Wiss K (2011) Becker nevus with ipsilateral breast and areolar hypoplasia. J Am Acad Dermatol 64(2):AB137
Baeta IGR, Viotti CV, Pereira ACF, Da Costa Jr SR, Bittencourt FV (2010) Becker’s nevus syndrome—case report. An Bras Dermatol 85(5):713–716
Cosendey FE, Martinez NS, Bernhard GA, Dias MFRG, Azulay DR (2010) Becker nevus syndrome. An Bras Dermatol 85(3):380–384
Fernandes C, Agrawal A, Shreshtha BB, Yogi N, Cherian I (2010) Becker’s nevus syndrome with quadriparesis. BMJ case reports doi:10.1136/bcr.06.2010.3117
Sirka CS, Puhan MR, Behera S, Mohanty P, Nanda M (2009) Becker’s nevus with ipsilateral breast hypoplasia. Indian J Dermatol Venereol Leprol 75(2):202–203
Alfaro A, Torrelo A, Hernandez A, Zambrano A, Happle R (2007) Becker nevus syndrome. Actas Dermosifiliogr 98(9):624–626
Rasi A, Taghizadeh A, Yaghmaii B, Setareh-Shenas R (2006) Becker’s nevus with ipsilateral breast hypoplasia: a case report and review of literature. Arch Iran Med 9(1):68–71
Moon SH, Yeo KY, Kim JS, Yu HJ (2005) A case of Becker’s nevus associated with ipsilateral hypoplasia. Kor J Dermatol 43(1):118–120
Jung JH, Kim YC, Park HJ, Cinn YW (2003) Becker’s nevus with ipsilateral breast hypoplasia: improvement with spironolactone. J Dermatol 30(2):154–156
Santos-Juanes J, Galache C, Curto JR, Carrasco MP, Ribas A, Sanchez Del Rio J (2002) Acneiform lesions in Becker’s nevus and breast hypoplasia. Int J Dermatol 41(10):699–700
Angelo C, Grosso MG, Stella P, De Sio C, Passarelli F, Puddu P et al (2001) Becker’s nevus syndrome. Cutis; Cutan Med Pract 68(2):123–124
Maradeix S, Reichert-Penetrat S, Weber F, Taillandier L, Barbaud A, Schmutz JL (2001) Difficult management of Becker’s naevus with ipsilateral breast hypoplasia. Nouvelles Dermatol 20(3):218
Pranteda G, Bottoni U, De Simone P, Rota L, Capaccetti B, Pistola G et al (1999) Becker’s nevus associated with ipsilateral breast hypoplasia. G Ital Dermatol Venereol 134(6):591–594
Crone AM, James MP (1997) Giant Becker’s naevus with ipsilateral areolar hypoplasia and limb asymmetry. Clin Exp Dermatol 22(5):240–241
Sharma R, Mishra A (1997) Becker’s naevus with ipsilateral areolar hypoplasia in three males. Br J Dermatol 136(3):471–472
Ibrahim KTT, Bahamndan KA, Khare AK (1995) Becker’s nevus and ipsilateral breast hypoplasia. Gulf J Dermatol 2(2)
Cambiaghi S, Brusasco A, Tadini G, Alessi E (1994) Congenital Becker’s nevus with ipsilateral breast hypoplasia. G Ital Dermatol Venereol 129(4):169–172
Querol ICA, Cisneros CT, Moros JS (1994) Nevus de Becker e hipoplasia mamaria ipsilateral. Present Acta Dermosifiliogr 85:441–444
Cisneros Lanuza MT, Querol Nasarre I, Cordoba Iturriagagoitia A, Moros Garcia JS (1993) Skeletal anomalies and epidermal nevi. Report of three cases. Rehabil Fisica XXI 4(18):29–33
Van Gerwen HJL, Koopman RJJ, Steijlen PM, Happle R (1993) Becker’s naevus with localized lipoatrophy and ipsilateral breast hypoplasia. Br J Dermatol 129(2):213
Blanc F, Jeanmougin M, Civatte J (1988) Becker’s nevus with breast hypoplasia. Ann Dermatol Venereol 115(11):1127–1128
Friedel J, Champy M, Seltan A, Grosshans E (1988) What is your diagnosis? Becker’s nevus with ipsilateral mammary hypoplasia. Ann Dermatol Venereol 115(10):1059–1060
Moore JA, Schosser RH (1985) Becker’s melanosis and hypoplasia of the breast and pectoralis major muscle. Pediatr Dermatol 3(1):34–37
Glinick SE, Alper JC, Bogaars H, Brown JA (1983) Becker’s melanosis: associated abnormalities. J Am Acad Dermatol 9(4):509–514
Copeman PW, Jones EW (1965) Pigmented hairy epidermal nevus (Becker). Arch Dermatol 92(3):249–251
Poletti-Vázquez EDH-CA, Pedroza-Cepeda CE, Flores-Rodríguez FA, Ramírez-Ruíz MM (2016) Síndrome de nevo de Becker. Dermatol Rev Mex 60(3):247–252
Ho Quoc C, Fakiha M, Meruta A, Dlimi C, Piat JM, Delay E (2015) Breast lipofilling: a new treatment of Becker nevus syndrome. Ann Chir Plast Esthet 60(4):336–339
L-V MT (2015) Sindrome de nevo de Becker. FMC 22(7):399–400
Bisht YS, Bhasin R, Manoj S, Sunita BS, Singhal E (2013) Becker’s nevus syndrome. Medical Journal Armed Forces India
Urbani CE, Betti R (1998) Polythelia within Becker’s naevus. Dermatol (Basel, Switzerland) 196(2):251–252
Sudip K. Ghosh M, DNB, Biswajit Majumder, MD, DM, FACC, and Megha Agarwal, MBBS (2016) Becker’s nevus syndrome: a report of a rare disease with unusual associations. doi:10.1111/ijd.13378
Urbani CE, Betti R (1995) Supernumerary nipples and Becker’s nevus: a previously undescribed association. Report of 9 patients including a subset with uropathies. Eur J Dermatol 5(8):685–687
Verma S, Sharma YK, Deo K, Gupta A (2014) Becker nevus syndrome; probably the first report of concurrent acrally located congenital BN, soft tissue hypertrophy and fused carpal bones. J Eur Acad Dermatol Venereol
Maessen-Visch MB, Hulsmans RFHJ, Hulsmans FJH, Neumann HAM (1997) Melanosis naeviformis of Becker and scoliosis: a coincidence? Acta Derm Venereol 77(2):135–136
Naranjo R, Delgado V, de Dulanto F, Herrera E, Armijo M (1980) Becker’s melanosis. Acta Dermosifiliogr 71(9–10):331–336
Chung HMCY, Chen CL, Wang WJ, Wong CK (2002) Becker’s melanosis associated with ipsilateral lower limb hyperplasia and pectus excavatum: a case report and review of the literature. Dermatol Sin 20:27–32
Glinick SE, Alper JA (1986) Spectrum of Becker’s melanosis changes is greater than believed. Arch Dermatol 122(4):375
Hulsmans FJHHR, Dijkstra PF, Van Ooy A (1989) Abnormalities of soft tissue and bone associated with melanosis naeviformis of Becker—a clinicoradiological study of 40 patients. Br J Dermatol 121(4):521–540
KSPJDCEMAA JB (2015) Expanding the phenotype of facioscapulohumeral muscular dystrophy: a rare association with Becker’s naevus: a case report. Ann Ind Acad Neurol 18(6):S59–S60
Zárate-Moysén A, Feregrino-Hernández HE, Delgado-Fernández A, Vega-Memije E (1992) Becker’s melanosis: a case report. Bol Med Hosp Infant Mex 49(11):762–765
Lucky AW, Saruk M, Lerner AB (1981) Becker’s nevus associated with limb asymmetry. Arch Dermatol 117(4):243
Chapel TA, Tavafoghi V, Mehregan AH, Gagliardi C (1981) Becker’s melanosis: an organoid hamartoma. Cutis 27(4):405–406+410
Metin A, Tuncay I, Ugras S (2001) About the paper “Elephantiasis neuromatosa and Becker’s melanosis” (J Dermatol, 26: 396-398, 1999). J Dermatol 28(2):112–113
Akyol M, Ozcelik S, Marufihah M, Elagoz S (1999) Elephantiasis neuromatosa and Becker’s melanosis. J Dermatol 26(6):396–398
Dasegowda SB, Basavaraj G, Nischal K, Swaroop M, Umashankar N, Swamy SS (2014) Becker’s nevus syndrome. Ind J Dermatol 59(4):421
Ruggieri M, Pratico AD (2015) Mosaic neurocutaneous disorders and their causes. Semin Pediatr Neurol 22(4):207–233
Knutson GA (2005) Anatomic and functional leg-length inequality: a review and recommendation for clinical decision-making. Part I, anatomic leg-length inequality: prevalence, magnitude, effects and clinical significance. Chiropr Osteopat 13:11
Subotnick SI (1981) Limb length discrepancies of the lower extremity (the short leg syndrome). J Orthop Sports Phys Ther 3(1):11–16
Badii M, Wade AN, Collins DR, Nicolaou S, Kobza BJ, Kopec JA (2014) Comparison of lifts versus tape measure in determining leg length discrepancy. J Rheumatol 41(8):1689–1694
Alshaiji JM, Handler MZ, Huo R, Freedman A, Schachner LA (2014) HATS syndrome: hemimaxillary enlargement, asymmetry of the face, tooth abnormalities, and skin findings. Cutis 94(4):E18–E21
Chan SA, Rajasekaran AV (2014) Facial Becker nevus associated with fibrous dysplasia and facial asymmetry. J Am Acad Dermatol 70(5):AB44
Petraud A, Sury F, Perrinaud A, De Pinieux G, Laure B, Goga D (2013) Becker’s nevus and hemimaxillary hypoplasia: coincidence or syndrome? Rev Stomatol, Chir Maxillofac Chir Orale 114(1):34–37
Welsch MJ, Stein SL (2004) A syndrome of hemimaxillary enlargement, asymmetry of the face, tooth abnormalities, and skin findings (HATS). Pediatr Dermatol 21(4):448–451
Kim HJ, Kim KD, Lee MH (2002) Becker’s melanosis associated with fibrous dysplasia. Int J Dermatol 41(7):384–386
Jones AC, Ford MJ (1999) Simultaneous occurrence of segmental odontomaxillary dysplasia and Becker’s nevus. J Oral Maxillofac Surg 57(10):1251–1254
Miles DA, Lovas JL, Cohen MM Jr (1987) Hemimaxillofacial dysplasia: a newly recognized disorder of facial asymmetry, hypertrichosis of the facial skin, unilateral enlargement of the maxilla, and hypoplastic teeth in two patients. Oral Surg, Oral Med, Oral Pathol 64(4):445–448
Danforth RA, Melrose RJ, Abrams AM, Handlers JP (1990) Segmental odontomaxillary dysplasia. Report of eight cases and comparison with hemimaxillofacial dysplasia. Oral Surg, Oral Med, Oral Pathol 70(1):81–85
Whitt JC, Rokos JW, Dunlap CL, Barker BF (2011) Segmental odontomaxillary dysplasia: report of a series of 5 cases with long-term follow-up. Oral Surg, Oral Med, Oral Pathol, Oral Radiol, Endod 112(2):e29–e47
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
Martina E. Schneider, Elmar Fritsche, Urs Hug, and Pietro Giovanoli declare that they have no conflict of interest.
Patient consent
All patients signed the consent statement before their inclusion in this study.
Funding
No funding was received to assist with the creation of this manuscript.
Ethical approval
For this kind of study formal consent of the local ethics committee is not required.
Rights and permissions
About this article
Cite this article
Schneider, M.E., Fritsche, E., Hug, U. et al. Becker nevus syndrome and ipsilateral breast hypoplasia: a systematic literature review. Eur J Plast Surg 40, 489–498 (2017). https://doi.org/10.1007/s00238-017-1327-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00238-017-1327-6