Facial hyperpigmented lesions that are unilateral are a rare and challenging dermatological anomaly since birth which can be genetic and non-genetic. This paper seeks to provide an exhaustive overview of the etiology, clinical presentation, differential diagnosis, and management strategies for these congenital lesions. Unilateral facial hyperpigmented lesions can be caused by a number of conditions, such as congenital melanocytic nevi, Becker\'s nevus, nevus of Ota, linear epidermal nevi, and café-au-lait macules. Accurate diagnosis requires meticulous examination, dermoscopy, and histopathological evaluation. Observation, topical therapies, surgical excision, and laser therapy are among the available treatment options. Treatment decisions should be influenced by factors such as lesion characteristics, aesthetic concerns, and patient preferences. Long-term supervision and psychosocial support are indispensable elements of comprehensive management. We present a case of a 12-year-old patient with a progressively growing hyperpigmented lesion on the right side of the face, present since birth with an intermittent area of normal skin in between. Dermoscopy unveiled an irregular, dark brown pigment network, and histopathological evaluation showed an increased number of melanocytes in the dermis. This case highlights the diagnostic challenges of such lesions and underscores the significance of a multidisciplinary approach for accurate evaluation and management. This paper aims to cover existing knowledge gaps regarding unilateral facial hyperpigmented lesions since birth and direct future research efforts for diagnostic and therapeutic interventions.

Nevus is a group of melanocytes that grow together to form a benign growth on the skin. It is often a black lesion that may protrude from the skin. Becker\'s nevus is a hyperpigmented lesion that presents congenitally or is acquired. The pigmentation and unusually high hair growth might grow darker with time. Becker\'s nevus, which can interchangeably be called Becker\'s melanosis, is a rare disease usually presented by men. The following case is of a 21-year-old male who presented with a hyperpigmented lesion on his right arm. The lesion started at age 16 and increased in size gradually; it involved the flexor surface of the right elbow joint and showed hypertrichosis with irregular margins. On examination, the top dermis contained melanophages, and the basal layer was hyperpigmented. Based on clinical appearance and examination, Becker\'s nevus was diagnosed.

Becker\'s nevus (BN) is one of the cutaneous hamartomatous lesions that often presents as an acquired, single unilateral pigmented hairy patch on the upper trunk, scapular region, or upper arm. Hereby we introduce a 13-year-old girl with the unusual manifestation of BN with multiple acquired, pigmented hairy patches for six months without any musculoskeletal or developmental involvements. After carefully reviewing the literature, to the best of our knowledge, this is the first case in this regard in Iran.

Becker\'s nevus (BN) is an acquired unilateral hyperpigmented hairy macule, whereas morphea is a chronic connective tissue disease of unknown etiology, characterized by skin thickening with increased quantities of collagen in the indurated lesion, usually involving the upper trunk and proximal extremity. The occurrence of both disease in the same anatomical site and individual was not reported previously. We report this rare case in a 17-year-old, Indian girl and was diagnosed after clinical histopathology and dermoscopic correlation. Morphea can be an interesting incidental occurrence within a large plaque of BN.

BACKGROUND: Becker\'s nevus is a common skin disorder. Lasers and light instruments are the major modalities for the treatment of Becker\'s nevus, but the outcomes were mixed.
OBJECTIVE: To evaluate the efficacy of the intense pulsed light for Becker\'s nevus in a large Chinese cohort.
METHODS: We retrospectively analyzed the efficacy of the intense pulsed light for Becker\'s nevus in a single center.
RESULTS: A total of 45 patients, including 26 males and 19 females (male to female ratio = 1.4), aged 5-42 years, were included in this analysis. Twenty-seven patients (60%) were with hypertrichosis. Treatments with intense pulsed light resulted in over 75% improvements in pigmentation and hair density in 1 and 2 cases, respectively. One patient displayed 51%-75% reductions in hair density. The rest displayed ≤50% improvements in pigmentation and hair density. Recurrence occurred in all cases within 6 months after the last treatment. Adverse reactions were temporary and mild hypopigmentation, hyperpigmentation, hypertrophic scar, pain, and erythema.
CONCLUSIONS: Intense pulsed light does not exhibit long-term benefits for Becker\'s nevus. Further studies in the large cohort are still required to validate the present results. Moreover, whether changes in the treatment parameters can improve the efficacy of intense pulsed light remains to be explored.

Becker\'s nevus, also known as pigmented hairy epidermal nevus, is characteristically described as a unilateral, hairy, light to dark brown macule with sharply outlined but irregular border. The etiopathogenesis of Becker\'s nevus is still not clearly understood. Perifollicular pigmentation has been described earlier by some authors. But, Becker\'s nevus presenting exclusively with follicular lesions has not been described. We are reporting a series of patients of Becker\'s nevus with follicular lesions. The diagnosis in all the patients was made after clinicopathological correlation. Follicular epithelium may hold a significant role in the etiopathogenesis of Becker\'s nevus.

UNASSIGNED: Becker\'s Nevus (BN) is a benign hamartoma with an esthetically troublesome condition secondary to hyperpigmentation and hypertrichosis. Many treatment modalities have been utilized with variable outcomes.
UNASSIGNED: To evaluate the efficacy and safety of intense pulsed light (IPL) in the treatment of BN.
UNASSIGNED: IPL was used at filter of 590 nm, fluence of 18-22 J/cm2, double-pulse mode (pulse width of 3-10 ms, pulse delay of 20-30 ms) at 3-month intervals. Final evaluations were performed by physician global assessment and patient satisfaction. Side effects were monitored at each treatment session and follow-up visit.
UNASSIGNED: Twenty-four patients (9 females, 15 males) with BN (16 hypertrichotic, 8 atrichotic) completed the study. The mean number of treatment sessions was 5 ± 2.17. The improvement in atrichotic BN group (4.87 ± 0.35) was significantly greater than that observed in hypertrichotic BN group (3.63 ± 0.89) (p = .001). Hair density simultaneously decreased with treatment in hypertrichotic BN. The mean satisfaction score was 5.75 ± 2.05 and 8 ± 0.93 in hypertrichotic and atrichotic BN groups respectively (p = .002). No repigmentation was noted during the follow-up period. No permanent side effects were observed.
UNASSIGNED: IPL is an effective and well-tolerated treatment option for patients with hypertrichotic and atrichotic BN.

BACKGROUND: Patients with epidermal nevi strongly demand cosmetic improvement. Laser treatment appears appealing and is frequently used in clinical practice. Nevertheless, large series with long-term follow-up are missing, preventing definitive conclusions about its real benefit.
OBJECTIVE: To evaluate the long-term effectiveness and safety of lasers for epidermal nevi.
METHODS: Bicentric, retrospective, cohort study, including all patients treated with a laser for an epidermal nevus with more than a 1-year follow-up.
RESULTS: Seventy patients were treated for different types of epidermal nevi, mostly with ablative lasers: 23 verrucous epidermal nevi, 16 nevi sebaceous, 26 Becker nevi, 2 inflammatory linear verrucous epidermal nevi, 1 smooth-muscle hamartoma, 1 rounded and velvety epidermal nevus, and 1 nevus lipomatosus superficialis. The follow-up period was a median of 37 months (range, 12-127 months). Better results, fewer recurrences, and higher patient satisfaction were noted in treatments for verrucous epidermal nevi than for nevi sebaceous. Q-switched lasers failed to show any degree of improvement in almost all patients with Becker nevus.
CONCLUSIONS: The retrospective nature of the study.
CONCLUSIONS: Ablative lasers can treat verrucous epidermal nevi with good long-term esthetic results but have limited long-term efficacy for nevus sebaceous. Q-switched lasers failed to improve Becker nevi.

Several dermatoses have been reported in association with Becker\'s nevus. Eczematous dermatitis associated with Becker\'s nevus is extremely rare, described in only two previous case reports. We report a case of 21-year-old male with recurrent eczema lesions which were always localized within the underlying Becker\'s nevus lesion. This case may be explained as a Wolf\'s isotopic response-like phenomenon.

BACKGROUND: Facial hypermelanosis is a significant cause of cosmetic disfigurement, social embarrassment and psychological morbidity affecting quality of life.
OBJECTIVE: To study clinicoepidemlogic patterns of facial hypermelanoses among men.
METHODS: Medical records of all adult males presenting with facial hypermelanoses were analyzed for this retrospective cross sectional study for demographic details, duration, cosmetic usage, sun exposure, drug intake, infections, systemic or cutaneous diseases, and family history of hypermelanotic dermatosis. Laboratory investigations and skin biopsy were performed when deemed necessary.
RESULTS: These were 300 Indian men aged 18 to 74 (mean 37.35) years with 121 (40.3%) individuals aged 31-50 years. Various patterns of melasma in 230 (76.7%) patients were the major cause of facial hypermelanosis. Periorbital hypermelanosis was observed in 32 (10.7%), freckles and lentigens in 26 (8.7%), acanthosis nigricans in 12 (4%) and lichen planus pigmentosus in 10 (3.3%), pigmented cosmetic contact dermatitis in 7, and nevus of Ota in 6 persons. The 71 (30.8%) patients with melasma had a history of frequent sun exposure, 9 (3.9%) patients had systemic comorbidities. Family history of periorbital melanosis was present in 7 (21.8%), personal or family history of atopy in 5 (15.6%) patients. Acanthosis nigricans was associated with obesity in 9 (75%) of patients and with diabetes mellitus in 4 (33.3%) cases.
CONCLUSIONS: Melasma, periorbital hypermelanosis, acanthosis nigricans and lichen planus pigmentosus remain the predominant causes for facial hypermelanosis in men.