Pigmented hairy lesion over the shoulder

A 25-year-old man presented to our clinic with an asymptomatic and well-demarcated area of dark-brown pigmentation over the right shoulder overlying hypertrichosis limited to the boundaries of the pigmentation [Figure 1] for the past 10 years. The hyperpigmentation was surrounded by multiple smaller satellite areas of dark-brown pigmentation. He did not have any soft tissue or bony abnormality, limb shortening/enlargement, scoliosis, or breast hypoplasia. Based on the characteristic presentation, we made a diagnosis of Becker’s nevus. Becker’s nevus manifests as a unilateral, hyperpigmented, and hypertrichotic lesion over the shoulder and chest during adolescence.^[1] It is a benign cutaneous hamartoma of ectodermal- and mesodermal-derived tissues. Patients with Becker’s nevus should be examined for soft tissue or bony abnormalities to rule out Becker nevus syndrome. Treatment options for Becker’s nevus include electrolysis, waxing, and laser treatment with Q-switched ruby and Nd: YAG lasers.

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Figure 1:

An asymptomatic and well-demarcated area of dark-brown pigmentation surrounded by multiple smaller satellite areas of pigmentation over the right shoulder with overlying hypertrichosis limited to the boundaries of the pigmentation.

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