Becker's Melanosis, Clinical Case, Nevus, Teledermatology



  1. Jacob, Sharon E.


ABSTRACT: Teledermatology is a term to describe the provision of dermatologic medical services through telecommunication technology. In this modality, there is transfer of medical information electronically (e.g., clinical history and visual data) on a patient in one location to a provider who is in another location. The construct of this column is such that cases are presented in a standardized teledermatology reader format. This is a case of a brown hair-bearing patch presenting on the trunk.


Article Content




Chief complaint: presenting for diagnosis of a lesion.


History of present illness: a 26-year-old gentleman presents with a "brown spot with hair" (primary lesion) on his trunk (location) that he believes he noticed in high school (~10 years ago, duration). Prior treatment: none. His primary symptom: this lesion is asymptomatic. Prior biopsy: none. He has no personal or family history of skin cancer or melanoma. Other significant laboratory/study findings: none.


Image Quality Assessment (Evaluation of Image Quality by Teledermatology Provider)

Fully satisfactory.


[Evaluator picks one: Fully satisfactory/marginal satisfactory with suggestions for improvement/unsatisfactory]


Teledermatology Imaging Reader Report

One image was provided that shows a diffuse asymmetric tan-to-brown patch with overlying hypertrichosis (terminal hairs, coarser than the surrounding body hair) involving the central and left chest (Figure 1).

Figure 1 - Click to enlarge in new windowFIGURE 1. Image A demonstrating lesion on left torso.

Interpretation of Images

Lesion A

Findings. The presented lesion and history of peripubertal presentation is consistent with the diagnosis of a Becker's melanosis (Becker's nevus).



Skin care and treatment recommendations

We recommend reassurance of the benign nature of this lesion to the patient. Per patient preference, cosmetic treatment options include electrolysis, waxing, excision and grafting, and laser-assisted hair removal.



Type of visit

Return to primary provider for reassurance and for discussion of cosmetic options, if patient would like to pursue treatment.


[Type of visit: completing teledermatology provider picks one: return to primary provider for treatment/refer to dermatology clinic for evaluation (face to face)/lesion is benign, recommend reassurance and follow-up as needed pro re nata (PRN).



The pathogenesis of Becker's nevus is unknown; however, androgens are thought to play a role, given the male predominance, peripubertal development, hypertrichosis, and occasional development of associated acneiform papules within the lesions. Becker's nevus is believed to be a benign process. It may be associated with smooth muscle hamartoma, hypoplasia of underlying structures, ipsilateral limb shortening, localized lipoatrophy, and accessory scrotum (Rivers, 2014).




Rivers, J. K. (2014). Becker's melanosis clinical presentation. Medscape. Retrieved from[Context Link]


1The standardized teledermatology reader report format is available for authors on the Journal's Web site ( [Context Link]