The correct answer is A. Ipsilateral breast hypoplasia.

Becker’s nevus is a cutaneous hamartoma of ectodermal and mesodermal tissues that typically arises around puberty, most often in males. When Becker’s nevus occurs in association with extracutaneous abnormalities, the condition is termed Becker’s nevus syndrome. The most commonly reported extracutaneous finding is ipsilateral breast or chest hypoplasia, which may be subtle or pronounced. Other reported associations include asymmetric limb hypoplasia or hypertrophy, scoliosis, spina bifida occulta, and supernumerary nipples.

Option B, Hyperhidrosis, is not a described feature of Becker’s nevus or Becker’s nevus syndrome. Option C, Increased risk of malignancy, is incorrect, although isolated cases of melanoma within Becker’s nevus have been reported, no definitive association has been established. Option D, Poliosis, or localized white hair, is not associated with Becker’s nevus. Option E, Darier sign, refers to urtication after rubbing in mastocytomas or urticaria pigmentosa; Becker’s nevus instead may demonstrate pseudo-Darier’s sign, a transient piloerection due to increased piloerector muscles.

References: Alikhan A, Hocker TL. Review of Dermatology. 2nd ed. Elsevier; 2024.

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