Naevi and Other Developmental Defects

Adrienne S. Glaich, MD; Leonard H. Goldberg, MD, FRCP; Tianhong Dai, PhD; Joy H. Kunishige, MD; Paul M. Friedman, MD; DermSurgery Associates, Houston, Texas (Drs Glaich, Goldberg, and Friedman); and Departments of Dermatology, Weill Cornell Medical College, Methodist Hospital, Houston (Drs Goldberg and Friedman), Harvard Medical School, Boston, Massachusetts (Dr Dai), and The University of Texas Medical School, Houston (Drs Goldberg, Kunishige, and Friedman)

https://jamanetwork.com/journals/jamadermatology/articlepdf/654461/dce70002_1488_1490.pdf

Fractional Resurfacing A New Therapeutic Modality for Becker's Nevus

• Congenital smooth muscle hamartoma is a congenital skin lesion characterized by proliferation of bundles of smooth muscle within the reticular dermis. We report on a group of 15 children with this lesion, confirmed by skin biopsy specimen, its prevalence, the occurrence of associated anomalies, and long- term follow-up. To our knowledge, this is the largest group of patients with this lesion described in the literature. The estimated prevalence is about 1:2600 live births with slight male predominance. The lesion is most frequent in the lumbosacral area (67% [10/15]) and a positive pseudo-Darier's sign is present in 80% (12/15) of patients. During the follow-up period of up to 7 years, the lesions enlarged slightly but became less prominent. No malignant transformation was observed. (AJDC. 1990;144:782-784)

https://jamanetwork.com/HttpHandlers/ArticlePdfHandler.ashx?journal=PEDS&articleId=515227&pdfFileName=archpedi_144_7_024.pdf

Congenital smooth muscle hamartoma. Prevalence, clinical findings, and follow-up in 15 patients.

Case 1 A 9-year-old girl applied a temporary henna tattoo to her right arm and 1 week later repeated the same process. In the following 2 days, erythema and papulovesicular eruptions developed at the application site (Fig. 1). Patch tests were performed with the European Standard Series, specific hairdressing agents, and commercial and natural henna. The patient showed a 3+ reaction to both natural henna and ‘‘para-phenylenediamine (PPD)’' 1% and a 3+ reaction to nickel sulfate 5% at 48, 72, and 96 h (Fig. 2). She was treated with topical steroid cream (beclomethasone dipropionate), applied twice daily. A slight postinflammatory hypopigmentation was observed at the time of the patch test. The hypopigmentation has gradually decreased in severity over time (Fig. 3).




Figure 1. Case 1: temporary henna tattoo reaction with papulovesicular eruptions

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Figure 2. Case 1: patch test results. (A) 3+ reaction to nickel sulfate 5%; (B) 3+ reaction to para-phenylenediamine (PPD) 1%; (C) 3+ reaction to natural henna

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Figure 3. Case 1: postinflammatory hypopigmentation

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Case 2 An 11-year-old boy was admitted to our outpatient clinic with itchy, erythematous, papulovesicular eruptions on the left arm. These lesions appeared after application of a temporary henna tattoo with a ‘‘do-it-yourself’' kit to the left arm. Patch tests were performed with the European Standard Series and commercial tattoo products. The patient showed only a 1+ reaction to commercial henna. He was treated with topical steroid cream (beclomethasone dipropionate), and 2 weeks later his lesions had totally disappeared.



Case 3 A 12-year-old girl applied a temporary henna tattoo to her left arm. Several hours later, erythema, edema, and itching developed. Patch tests were performed as for Case 2. The patient showed a 2+ reaction to commercial henna. Topical steroid cream (beclomethasone dipropionate) was effective, and 3 weeks later the lesions had healed with slight hypopigmentation. The postinflammatory hypopigmentation traced the tattoo design exactly, which was in the form of a fish (Fig. 4). On follow-up, the hypopigmentation was not permanent.




Figure 4. Case 3: fish-shaped postinflammatory hypopigmentation

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Temporary henna tattoo reactions in children.

• Congenital pigmented arrector pili hamartomas are unique malformations of epidermis and pilar apparatus usually appearing as localized, lightly pigmented, hairy plaques. Characteristic microscopic features include smooth-muscle proliferation similar to irregularly disposed arrectores pilorum, and slight elongation of epidermal rete with hypermelanosis of the basal unit. An otherwise normally developed child who had this hamartoma at birth is described in an attempt to clarify the relationship between pilar smooth-muscle hamartomas and Becker's melanosis. We propose that these two entities belong at different poles of the same developmental spectrum of hamartomatous change. ( Arch Dermatol 1985;121:1034-1037)

https://jamanetwork.com/HttpHandlers/ArticlePdfHandler.ashx?journal=derm&articleId=546378&pdfFileName=archderm_121_8_021.pdf

Congenital arrector pili hamartoma-A case report and review of the spectrum of Becker's melanosis and pilar smooth-muscle hamartoma

The authors make a survey of a series of a hundred Becker's nevi diagnosed in a recruiting center of the French National Service. It is a statistic study bearing on the male population, aged 17 to 26, in a French region which is supposed to be representative of the French male population of the same age. First of all the authors focus on the various clinical descriptions since this nevus was first described by Becker in 1949, then discuss the problems raised by pathogenic interpretation and the results of microscopic studies. About this lesion, usually said to be pigmentary and hairy, and generally appearing before 20 years of age, is still very little known. Then after a short explanation of their method of study the authors give original results. A hundred Becker's nevi were diagnosed among 19,302 young men, that is to say in a proportion of 0.52 p. 100. A study of the racial, genetic and pigmentary background doesn't enable to retain general causes but rather leads to think of local causes. Half of these Becker's nevi appeared before ten years of age, the other half appearing between 10 and 20. In only one quarter of the cases can the role of the sun be pointed out. The location of the nevi is variable; they are mainly situated on the trunk and only 32 p. 100 of them are located above nipples, which was believed to be the usual place of the lesion. Pigmentation in three quarter of the cases is light brown. The average surface is 125 cm2. Hairs can be seen in only a little more than half of the cases of no lesion associated to the nevus could be found. The study points out that Becker's nevi seem to be more various in their clinical expression and more pigment than could be thought through more classical description.

[Late Becker's nevus. One hundred cases (author's transl)].

Naevus tardif de Becker. A propos d'une série de 100 observations.

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[Late Becker's nevus. One hundred cases (author's transl)].

Naevus tardif de Becker. A propos d'une série de 100 observations.