Successful treatment of Becker's nevus with dermabrasion by
Lasers have been widely used for treatment of Becker nevus. Here, authors report a case of Becker nevus which did not respond to laser therapy and was treated successfully by dermabrasion with sandpaper with no following complications.

The patient was an otherwise healthy 19-year-old female patient who presented to our dermatology department with the chief complaint of an irregular color change on her right shoulder and scapula since she was 15 years old. The lesion had developed in size over time. By the time she was referred to our dermatology department, the lesion was 20 × 20 cm. She did not complain of itching, bleeding, or scaling. She denied having any systemic diseases or using any drugs, and she did not have hypertrichosis.

After examining the patient, she was diagnosed with Becker's nevus, which was later confirmed by biopsy. There were no findings to support the diagnosis of other conditions. Re-evaluation of the patient by another dermatologist confirmed the diagnosis. We initiated laser therapy by Q-switched ruby laser (694 nm, energy: 5 J, spot size: 3 × 3 mm), but there were no signs of improvement after three sessions. Since laser therapy was unsuccessful, we decided to use the dermabrasion method to remove the epidermis and upper dermis in the affected area by Becker's nevus.

After injecting local anesthetics, they used a sterilized 180 grit sandpaper and removed epidermis and superficial dermis in a 10 × 10 cm surface manually in circular patterns. Prophylactic Cephalexin capsules and topical Mupirocin ointment were prescribed for the patient to use every 6 h for a week.

The patient was followed up for 3 months afterward and the procedure was not followed by any complications including skin bleeding, infection, scarring or skin discoloration. The lesion was successfully removed after only one session of dermabrasion and did not recur afterward. After the improvement of the selected area of the lesion, we decided to use dermabrasion on the whole surface of the lesion using the same exact procedure. The patient was followed up for any complications, and the lesion was significantly improved after 3 months.