Ann Dermatol.  2016 Dec;28(6):697-703. 10.5021/ad.2016.28.6.697.

Clinicopathological Features and Immunohistochemical Alterations of Keratinocyte Proliferation, Melanocyte Density, Smooth Muscle Hyperplasia and Nerve Fiber Distribution in Becker's Nevus

• Sheng P
• Cheng YL
• Cai CC
• Guo WJ
• Zhou Y
• Shi G
• Fan YM

• KMID: 2368119
• DOI: http://doi.org/10.5021/ad.2016.28.6.697

Abstract

BACKGROUND
Although Becker's nevus (BN) is a relatively common disease, the systematic studies of clinicopathological and immunohistochemical results are poorly reported.
OBJECTIVE
To investigate the clinicopathological features and immunohistochemical alterations of keratinocyte proliferation, melanocyte density, smooth muscle hyperplasia and nerve fiber distribution in BN.
METHODS
Clinical and pathological data were collected in 60 newly-diagnosed BN cases. Immunohistochemical stain of Ki-67, Melan-A, keratin 15, smooth muscle actin and protein gene product 9.5 was performed in 21 cases.
RESULTS
The median diagnostic and onset age was 17 and 12 years, respectively. Skin lesions usually appeared on the upper trunk and upper limbs. The pathological features included the rete ridge elongation and fusion and basal hyperpigmentation. Epidermal Ki-67, Melan-A and keratin 15 expression and dermal nerve fiber length were significantly higher in lesional and perilesional skin than in normal skin (p<0.05~0.01), while smooth muscle actin expression was upregulated only in skin lesion (p<0.05).
CONCLUSION
Although the clinical diagnosis of BN is often straightforward, histopathology is helpful to differentiate from other pigmentary disorders. The hyperproliferation of keratinocytes, melanocytes, arrector pili muscle and dermal nerve fibers could be involved in the pathogenesis of BN.

Keyword

Becker's nevus; Keratinocytes; Keratins; Melanocytes

MeSH Terms

Actins
Age of Onset
Diagnosis
Hyperpigmentation
Hyperplasia*
Keratin-15
Keratinocytes*
MART-1 Antigen
Melanocytes*
Muscle, Smooth*
Nerve Fibers*
Nevus*
Skin
Upper Extremity
Actins
Keratin-15
MART-1 Antigen

Figure

• 

  Fig. 1 Clinicopathologic images of Becker's nevus in an 18-year-old man. (A) A brown hypertrichotic patches with multiple papules on the right chest. (B) Keratotic plugging, acanthosis, mild rete ridge elongation and fusion, basal hyperpigmentation, as well as smooth muscle and sebaceous hyperplasia and superficial perivascular lymphohistiocytic infiltration in the dermis (H&E, ×40).

• 

  Fig. 2 Epidermal Ki-67, Melan-A, and keratin 15 (K15) expression in lesional skin (A, C, E) was higher than in perilesional skin (B, D, F). Follicular K15 expression was located in the outermost layer of outer root sheath at the isthmus level (E, F) (immunostaining, ×200).

• 

  Fig. 3 Smooth muscle actin expression in arrector pili muscle, vessel walls, dermal sheath of hair follicles in lesional (A) and perilesional (B) skin (immunostaining, ×100).

• 

  Fig. 4 Protein gene product 9.5+ nerve fibers in the arrector pili muscle and neuroplexus in lesional (A) and perilesional (B) skin (immunostaining, ×400).

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