This case report explores a rare manifestation of Becker\'s nevus, where the patient exhibited an unusual dermatomal distribution featuring a hyperpigmented, irregular patch with associated hypertrichosis on the T4 segment. While Becker\'s nevus is a well-known dermatological condition typically observed in the upper back region, instances of dermatomal distribution are exceptionally uncommon. This case presents a unique occurrence of segmental Becker\'s nevus, highlighting the atypical presentation of this condition.

Pigmented hairy epidermal nevus, also known as Becker\'s nevus, has a typical description as a unilateral, hairy in appearance, light to dark brown patch with an irregular but clearly defined border. However, the exact aetiopathogenesis is still poorly comprehended. We report the case of a 19-year-old female who presented with asymptomatic brownish-pigmented macular lesions on the right breast that had slowly increased in size over the past three years. Upon cutaneous inspection, the right breast had 3-5 mm rounded and oval perifollicular macules that ranged from light to dark brown hue without increased hair growth. The macules were discrete and in no particular pattern. Dermoscopy of the lesions showed well-defined perifollicular hypopigmentation surrounded by a pigmented network-like pattern. Histopathology of a punch biopsy taken from one of the follicular lesions demonstrated an increase in basal layer pigmentation with elongation of rete ridges and acanthosis, consistent with Becker\'s nevus. The patient underwent three sittings of diode laser therapy, once in four weeks, with slight improvement in pigmentation.

Becker\'s nevus (BN) is a kind of epidermal cutaneous hamartoma. A noticeable hyperpigmented patch with a big, unilateral, hyperpigmented macule and irregularly shaped borders is the manner in which BN often presents. In this case, a 16-year-old boy has asymptomatic dark brown colored follicular macule on the left side of the cheek shortly after birth. The lesions were initially inconspicuous but gradually became darker as time passed. The macules on some of them grew hair. This case of BN with apparent hypertrichosis on one side of the cheek, which made it challenging to make a differential diagnosis with whiskers. The primary point of differentiation is that the lesions of BN only appear unilaterally. On the other hand, the face has whiskers on both sides. Additionally, BN will show hyperpigmentation whereas whiskers do not. In conclusion, for its unusual clinical presentation, we believe that reporting this case may help dermatologists avoid misdiagnosing similar cases.

Becker\'s nevus, also known as Becker\'s melanosis or Becker\'s pigmentary hamartoma, is a concurrent melanosis first described by S. William Becker. It is a type of acquired hyperpigmentation characterized by well-defined, unilateral lesions with regular borders. It is associated with hypertrichosis and hyperpigmented brownish patches with a mean diameter of 15 cm. The shoulder, scapular area, and upper arms are the most commonly affected areas, but it can occur on any area of the body, including the forehead, face, neck, lower trunk, extremities, and buttocks. The lesion usually appears around puberty, and males are more likely to be affected than females. A 27-year-old male of Arabic descent who was medically free presented to the dermatology clinic complaining of bilateral, symmetrical, hyperpigmented patches on the upper back. The lesions started almost at birth, gradually growing in size and darkening in color over time. On local skin examination, the lesions were bilateral, symmetrical, hyperpigmented patches on the upper back. They were both homogeneous and brown in color with irregular borders and blotchy hyperpigmented macules on both sides of the upper back associated with sparse hair development. Histopathological examination revealed epidermal hyperkeratosis, acanthosis, and focal regular elongation of rete ridges with clubbing. Increased basal layer pigmentation was noticed. The dermis showed focal areas with pigment incontinence. Based on the above clinicopathological findings, the patient was diagnosed with Becker\'s melanosis. He was referred to the laser clinic for further treatment.

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Becker\'s nevus is a relatively common skin lesion with brown hyperpigmentation and hypertrichosis. It may be expressed simultaneously with other cutaneous, muscular, or skeletal defects, such as hypoplasia of the breast or scoliosis, for which the term \"Becker\'s nevus syndrome\" has been proposed. An 8-year-old boy presented with a Becker\'s nevus on the right cheek, chin, and upper neck with alveolar bone hypertrophy in the anterior mandible, which led to an anterior crossbite and severe canting of the mandibular anterior teeth. Through orthopedic treatment using a face mask, the anteroposterior jaw relationship was improved. In phase 2 treatment, we corrected the canting of the mandibular anterior teeth with a segmental intrusion of the mandibular anterior right teeth into the hypertrophic alveolar bone area. The facial profile was improved along with acceptable occlusion, and the treatment result was stable at 1 year after the end of the treatment, without any periodontal attachment loss, root resorption of mandibular anterior teeth, or increase in the size of the hypertrophic region. This case report describes the successful comprehensive treatment of a growing patient with skeletal Class III malocclusion and multiple characteristics of Becker\'s nevus syndrome.

Becker\'s nevus is a common pigmented dermatosis, usually featured by ipsilateral pigmented patch with hypertrichosis. Becker\'s nevus is often treated with various types of lasers although other regimens are available. However, clinical outcomes appear inconsistent among studies. To summarize the clinical outcomes of Becker\'s nevus treated with lasers via literature review. A variety of lasers had been used alone or in combination to treat Becker\'s nevus. Laser wavelengths used for Becker\'s nevus ranged from 504 to 10,600 nm, while the number of treatment varied from 1 to 12 sessions. The clinical outcomes were mixed although combination of lasers with different wavelengths appeared to achieve a better efficacy. Adverse effects were usually mild to moderate erythema. While lasers are relatively safe, their efficacy for Becker\'s nevus is moderate. It seems that combination therapy could improve the outcome. However, trials in larger group of patients are required to validate the efficacy of each type of lasers for Becker\'s nevus.

We report the case of a 12-year-old girl with a smooth muscle hamartoma of the right index finger. Smooth muscle hamartoma (SMH) is a congenital, relatively common disorder typically with predominance of autochthonal arrector pili muscles. An SMH can also rarely originate from smooth muscles of vessels in palmoplantar skin with the absence of pilosebaceous units. Because of overlapping histological features, the possibility of Becker\'s nevus being identical or associated with SMH has often been suspected by some authors.

BACKGROUND: Becker\'s Nevus is an aesthetically troublesome condition secondary to hyperpigmentation and hypertrichosis. Although several lasers have been employed with varying degrees of success, the exact devices and treatment parameters have yet to be elucidated.
OBJECTIVE: To assess the combination Nd:YAG and alexandrite laser as a safe and efficacious treatment for Becker\'s Nevus.
METHODS: In a 20-year-old Fitzpatrick Skin Type IV male, a Becker\'s Nevus was treated with six sessions of long-pulsed 1064 nm Nd:YAG laser at six-week intervals followed by five sessions of long-pulsed 755 nm alexandrite laser at three-month intervals.
RESULTS: This patient experienced a significant reduction in both hyperpigmentation and hypertrichosis after these treatment sessions. No serious adverse events were reported.
CONCLUSIONS: This case supports the use of combination long-pulsed 1064 nm laser and 755 nm laser as a safe and efficacious treatment for Becker\'s Nevus.

Becker\'s naevus is a hamartoma that often appears during puberty. Clinically this presents with a pigmented and often hairy patch most often on the shoulders. Treatment has always been challenging and lasers are often used with mixed results. This article reviews the evidence of all the laser treatments used in Becker\'s naevus and analyses the findings from the published studies and trials.