174:, groups of cells known as ectodermal clusters grow along the milk lines to form breasts. In normal development, two ectodermal clusters will form breasts; the rest of the ectodermal clusters will regress. If the rest of the ectodermal clusters continue growing, they will form accessory nipples. The cause of Becker's nevus is not well known yet. It is thought to be a congenital condition, but the appearance of the nevus can also be influenced by intense sun exposure or an individual's androgen levels. The Becker's nevus will often become more obvious during puberty, especially in male individuals. Other studies suggest it may relate to a genetic mutation of
105:
300:
newborns and children. They enrolled 146 white patients (men and women) with AMT out of a total of 2645 patients. 11 patients with AMT were found to have kidney and urinary tract abnormalities. The study concluded that multiple factors are of importance in the determination of an association. These factors include age, race, ethnic group, hypertension, alcoholism and recently embryonic development defects. They found that there was a significantly higher occurrence of kidney and urinary abnormalities in patients with AMT compared to the control group, but no association or correlation was concluded between them.
283:
nipples, with one of those children also having polycystic kidney disease. Another child had Becker's nevus but no supernumerary nipples but had Wilm's tumor (kidney cancer). Some studies on supernumerary nipples have found associations with a myriad of kidney and urinary tract abnormalities, including polycystic kidney diseases, hereditary renal cysts, and narrowing of the ureter tube. Patients with cancer of the urinary or genital systems have also been reported to have higher rates of supernumerary nipples.
113:
304:
no kidney/urinary tract abnormalities were found in his twin daughters' renal ultrasounds. Another case report by Hersh, recorded significant renal abnormalities in a family with polythelia. Both mother and daughter had significant renal cysts. These case reports provide controversial data regarding the association between polythelia and kidney/urinary tract abnormalities.
101:" is used to describe Becker's nevus occurring along with other skin, musculoskeletal, or other tissue abnormalities such as supernumerary nipples. There are some reports documenting an association between supernumerary nipples, Becker's nevus syndrome, and urinary tract abnormalities, although with conflicting results. This association has been dubbed "SNUB syndrome".
274:
urinary tract abnormalities. On the other hand, studies on supernumerary nipples have found an association between supernumerary nipples between kidney and urinary tract abnormalities. While the prevalence of urinary tract abnormalities is about 1-2% in the general population, the frequency can rise to about 14.5% in individuals with supernumerary nipples.
303:
In addition to clinical study findings, many published case reports have identified the presence (or absence) of kidney and renal abnormalities in patients with polythelia and familial polythelia. In one case report by A. Leung, renal abnormalities were found in a
Chinese father with polythelia, but
299:
In 1996, a study published by C. Urbani and R. Betti evaluated accessory mammary tissue (AMT) association with hereditary urinary and kidney abnormalities. Their study aimed to determine the significance of the association in the adult population since previous controlled studies were only based on
195:
Becker's nevus and supernumerary nipples can usually be diagnosed by visually observing the skin. However, if visual observation alone is insufficient to make a conclusive diagnosis, a skin biopsy can be performed. A small sample of skin can be removed from the nevus and examined under a microscope
220:
Since supernumerary nipples are commonly regarded as benign, treatment to remove it is usually done only for cosmetic purposes. In some cases, this skin abnormality can also cause discomfort around the breast tissue. This is particularly an issue when a component of the lesion is glandular tissue,
157:
Supernumerary nipples are presented in any shape and size along the milk line at birth, and it affects more males than females. They commonly present as 2-3 mm hyper-pigmented spots below the breast, chest, or abdomen at birth. However, they can also occur on the face, neck and back. Supernumerary
149:
Becker's nevus presents as a tan or brown patch of skin that most often occurs on chest, shoulder blade, or back, although it can occur on other parts of the body. This patch of skin can develop excess growth of coarse, dark hair years after the discoloration is first discovered. The term Becker's
295:
The correlation between the accessory nipples and renal abnormalities was first introduced by K. Mehes in 1979 in a study of 20 children with polythelia. In this study, eight out of the twenty children had kidney lesions, proving statistically significant data and concluded an association between
282:
The urogenital abnormalities seen with SNUB syndrome are more difficult to characterize, since very few studies have investigated individuals with all three symptoms (Becker's nevus, supernumerary nipples, uropathy). One study found multiple cases of children with Becker's nevus and supernumerary
129:
of breast tissue, so it falls under the umbrella term of accessory breast tissue (ABT). Accessory breast tissue has a classification system depending on how the condition presents in the individual. Separate terms are used for different combinations of the presence of nipple, areola, or glandular
307:
While these clinical studies and case reports provide controversial conclusions, the presence of polythelia in patients warrants physicians to be vigilant in their examinations and perform the necessary tests for kidney/urinary tract abnormality detections early in the course of their diagnosis.
273:
Genitourinary tumors, such as kidney or bladder cancers, have been reported to occur earlier in life and more often in individuals with epidermal nevus syndrome. However, there have not been sufficient controlled clinical studies to confirm the association between epidermal nevi and kidney and
291:
The association between polythelia and urinary tract abnormalities has not been fully established yet in either adults or children. In some clinical studies, the presence of polythelia or supernumerary nipples is an indication of the presence of nephro-uropathies in children, and in others, an
137:
SNUB syndrome may be considered part of the broader category of epidermal nevus syndromes, which is described as the presence of any type of epidermal nevus together with other developmental abnormalities in the skin, eyes, brain, heart, skeletal system, or urinary or genital systems.
260:
treatments, which are preferred for longer term effects. Proper diagnoses of the lesion can help to determine which treatment is appropriate, as well as reduce the risk of recurrence and side effects from the aforementioned procedures, such as post-inflammatory hyperpigmentation.
186:
Because of the rarity of SNUB syndrome, diagnostic methods for this particular syndrome have not been thoroughly described in the literature. Therefore, this section will describe diagnostic methods used for epidermal nevus syndromes, and Becker's nevus syndrome in particular.
161:
There is a wide range of kidney and urinary tract abnormalities reported to be associated with Becker's nevus or supernumerary nipples. However, whether there is a true association between uropathies, Becker's nevus, and supernumerary nipples is debated in the literature.
150:
nevus syndrome is used when an individual has a Becker's Nevus along with other developmental abnormalities. The most common abnormality is ipsilateral breast hypoplasia, where the breasts are asymmetrical in size, shape, or placement. Other abnormalities can include
322:
Epidermal nevi, such as Becker's nevus, have an incidence of about 0.1%, appearing equally in males and females. A majority of epidermal nevi appear during childhood and adolescence, with 80% appearing before age 1. New epidermal nevi rarely occur in adults.
94:, which are the precursors to breast and nipple development. Clinically, this congenital condition is generally considered benign, but some studies have suggested there may be an association with kidney diseases and cancers of the urogenital system.
221:
which can cause tenderness during puberty, and occasionally lactation. Although studies are still being done to establish an association between supernumerary nipples and kidney diseases, some researchers have proposed that
264:
Laser treatments may be pursued after careful consideration. In case the nevus is associated with another disease state, the affected area would no longer be available for histological examination after laser removal.
178:. Although some studies describe the association between supernumerary nipples, Becker's nevus, and urinary tract abnormalities as "SNUB syndrome", there is no clear causal relationship between the three conditions.
154:, fused ribs, asymmetry in other muscles, and supernumerary nipples. When Becker's nevus syndrome presents specifically with supernumerary nipples and urogenital abnormalities, it may be referred to as SNUB syndrome.
130:
tissue. The most common presentation, termed polythelia, is where only the nipple is present without the areola and glandular tissue. Conversely, the presence of all three components is known as polymastia, or
316:
The epidemiology of SNUB syndrome has not been thoroughly described in the literature, so this section will discuss the epidemiology of supernumerary nipples and Becker's nevus as separate conditions.
292:
association between the two has not been proven to be statistically significant. Studies have yet to show the association (or no association) in adults, but the majority have been linked to children.
158:
nipples can start growing by responding to hormone changes during adolescence, and can produce milk during pregnancy. Supernumerary nipples may be associated with kidney and vertebral malformation.
97:
Becker's nevus typically presents as a unilateral, non-cancerous patch of skin that is hyperpigmented and has excessive hair, often occurring on the chest, shoulder, and back. The term "
1057:
Urbani CE, Betti R (1995). "Supernumerary nipples and Becker's nevus : a previously undescribed association. Report of 9 patients including a subset with uropathies".
240:
compared to the unaffected skin. Consequently, treatments using drugs with anti-androgenic properties have shown efficacy in reducing the pigmentation. Particularly,
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916:
829:
558:
Urbani CE, Betti R (September 1997). "Supernumerary nipples occurring together with Becker's naevus: an association involving one common paradominant trait?".
200:, sweat glands, and hair follicles. There is also typically increased levels of melanin in the innermost layer of the skin, causing the darker discoloration.
90:, also referred to as polythelia or accessory nipples, is a pigmented lesion of the skin that is present at birth. This pigmentation usually occurs along the
1546:
Patrizi A, Medri M, Raone B, Bianchi F, Aprile S, Neri I (2012). "Clinical characteristics of Becker's nevus in children: report of 118 cases from Italy".
1422:
Patel P, Malik K, Khachemoune A (June 2015). "Sebaceus and Becker's Nevus: Overview of Their
Presentation, Pathogenesis, Associations, and Treatment".
1095:
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Armoni M, Filk D, Schlesinger M, Pollak S, Metzker A (September 1992). "Accessory nipples: any relationship to urinary tract malformation?".
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Individuals with SNUB syndrome will have the characteristic symptoms of Becker's Nevus, supernumerary nipples, and some type of uropathy.
990:
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Hersh JH, Bloom AS, Cromer AO, Harrison HL, Weisskopf B (September 1987). "Does a supernumerary nipple/renal field defect exist?".
1602:
Urbani CE, Betti R (May 1996). "Accessory mammary tissue associated with congenital and hereditary nephrourinary malformations".
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be used as a precautionary measure to detect any kidney abnormalities in this population and identify a need for treatment.
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are some examples which have been studied. Likewise, the excessive hair growth can be resolved by shaving, waxing, and
332:
232:
and hair growth. Correcting skin pigmentation can be done through a variety of methods including the use of makeup,
86:(also known as "SNUB syndrome") is a skin condition that may be associated with genitourinary tract abnormalities.
236:, or laser treatments. Studies have also established that the tissue of Becker's nevus has an increased number of
930:
Farhadieh R, Bulstrode N, Mehrara BJ, Cugno S (2022). Farhadieh RD, Bulstrode N, Mehrara BJ, Cugno S (eds.).
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Supernumerary nipples is a rare congenital disease that may happen in both females and males. During human
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Ultrasound, CT scans, and other imaging technology can be used to evaluate for kidney or bladder cancers.
390:
Finkelstein E, Meerkin DY, Weissman G (2018). "Nipples: A Sensitive Topic". In Tur E, Maibach HI (eds.).
222:
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can also be performed on urine samples to evaluate for other urinary tract problems, such as hematuria.
754:
Danarti R, König A, Salhi A, Bittar M, Happle R (December 2004). "Becker's nevus syndrome revisited".
257:
87:
1251:"Postzygotic Mutations in Beta-Actin Are Associated with Becker's Nevus and Becker's Nevus Syndrome"
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to analyze the cellular components. Epidermal nevi will typically contain an abnormal overgrowth of
425:"Supernumerary nipple and seminoma: case report and review of polythelia and genitourinary cancers"
1347:
Casey HD, Chasan PE, Chick LR (January 1996). "Familial polythelia without associated anomalies".
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Eguchi Y, Yoshinaka H, Hayashi N, Sueyoshi K, Uchikura K, Nomoto Y, et al. (September 2021).
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636:"Accessory breast cancer in the inframammary region: a case report and review of the literature"
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One factor that distinguishes supernumerary nipples from other skin lesions is that it has the
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Book SE, Glass AT, Laude TA (1997). "Congenital Becker's nevus with a familial association".
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Urbani CE, Betti R (March 1996). "Aberrant mammary tissue and nephrourinary malignancy".
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1090:(12th ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
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Méhes K (January 1983). "Association of supernumerary nipples with other anomalies".
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Supernumerary nipples have an incidence of 2-5.6%, occurring more commonly in males.
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Jones CE, Nouri K (March 2006). "Laser treatment for pigmented lesions: a review".
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Cai ED, Sun BK, Chiang A, Rogers A, Bernet L, Cheng B, et al. (August 2017).
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Der
Hautarzt; Zeitschrift für Dermatologie, Venerologie, und Verwandte Gebiete
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Leung AK, Robson WL (June 1990). "Renal anomalies in familial polythelia".
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The breast : comprehensive management of benign and malignant diseases
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Hughes, Mansel & Webster's benign disorders and diseases of the breast
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Jójárt G, Seres E (1994). "Supernumerary nipples and renal anomalies".
440:
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730:"Chapter 118. Benign Epithelial Tumors, Hamartomas, and Hyperplasias"
514:
Cosendey FE, Martinez NS, Bernhard GA, Dias MF, Azulay DR (2010).
111:
103:
881:
Bland KI, Klimberg VS, Copeland III EM, Gradishar WJ (2018).
394:. Cham: Springer International Publishing. pp. 139–170.
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Cosmetically treating Becker's nevus syndrome focuses on the
732:. In Goldsmith LA, Katz SI, Gilchrest BA, Paller AS (eds.).
467:"An update on Becker's nevus: Pathogenesis and treatment"
465:
Zhou YJ, Zheng DL, Hamblin MR, Xu YD, Wen X (July 2022).
84:
Supernumerary nipples–uropathies–Becker's nevus syndrome
33:
Supernumerary nipples–uropathies–Becker's nevus syndrome
736:(8th ed.). New York, NY: The McGraw-Hill Companies
843:
Mansel RE, Webster DJ, Sweetland H, Hughes LE (2009).
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Leung AK, Robson WL (September 1989). "Polythelia".
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985:(7th ed.). Philadelphia, PA: Elsevier Mosby.
728:Thomas VD, Snavely NR, Lee KK, Swanson NA (2012).
385:
383:
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1210:"Becker's Nevus and Lethal Beta-Actin Mutations"
61:Supernumerary nipple, uropathies, Becker's nevus
1322:. Treasure Island (FL): StatPearls Publishing.
609:. Treasure Island (FL): StatPearls Publishing.
296:supernumerary nipples and renal abnormalities.
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933:Plastic surgery : principles and practice
756:Journal of the American Academy of Dermatology
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734:Fitzpatrick's Dermatology in General Medicine
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360:Rapini RP, Bolognia JL, Jorizzo JL (2007).
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108:Drawing of a man with supernumerary nipples
964:: CS1 maint: location missing publisher (
915:: CS1 maint: location missing publisher (
828:: CS1 maint: location missing publisher (
287:Polythelia and genitourinary abnormalities
116:Becker's nevus on left shoulder & back
29:
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1693:American Journal of Diseases of Children
1424:American Journal of Clinical Dermatology
1389:American Journal of Diseases of Children
1255:The Journal of Investigative Dermatology
1214:The Journal of Investigative Dermatology
349:
957:
908:
821:
601:Saleh D, Yarrarapu SN, Cook C (2022).
423:Grimshaw EC, Cohen PR (January 2013).
77:Dermabrasion, laser treatments, makeup
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1506:
1504:
7:
1705:10.1001/archpedi.1987.04460090066027
1647:International Urology and Nephrology
1604:International Journal of Dermatology
1401:10.1001/archpedi.1990.02150300013007
1124:International Journal of Dermatology
1059:EJD: European Journal of Dermatology
692:"Supernumerary nipples: an overview"
685:
683:
681:
1616:10.1111/j.1365-4362.1996.tb03636.x
1511:Fritz K, Salavastru C (2020). "".
1179:10.1111/j.1525-1470.1997.tb00985.x
1136:10.1111/j.1365-4362.1989.tb02498.x
1028:10.1111/j.1525-1470.1992.tb00338.x
887:(5th ed.). Philadelphia, PA.
25:
690:Brown J, Schwartz RA (May 2003).
520:Anais Brasileiros de Dermatologia
278:SNUB and urogenital abnormalities
269:Clinical studies and case reports
1763:Cancer Genetics and Cytogenetics
1560:10.1111/j.1525-1470.2012.01734.x
1479:10.1111/j.1473-2165.2006.00216.x
1361:10.1097/00000637-199601000-00021
1467:Journal of Cosmetic Dermatology
533:10.1590/S0365-05962010000300015
252:. Other treatments of note are
1:
1740:10.1016/S0022-3476(83)80321-7
1084:Sadler TW, Langman J (2012).
1775:10.1016/0165-4608(95)00259-6
1087:Langman's medical embryology
979:Coran AG, Adzick NS (2012).
849:(3rd ed.). : Saunders.
400:10.1007/978-3-319-72156-9_11
338:List of cutaneous conditions
1824:
1525:10.1007/s00105-020-04716-x
800:(9th ed.). New York.
768:10.1016/j.jaad.2004.06.036
653:10.1186/s40792-021-01285-6
429:Dermatology Online Journal
1728:The Journal of Pediatrics
1436:10.1007/s40257-015-0123-y
1349:Annals of Plastic Surgery
1314:Pandey J, Syed W (2022).
1295:rarediseases.info.nih.gov
1268:10.1016/j.jid.2017.03.017
1227:10.1016/j.jid.2017.04.003
797:Fitzpatrick's dermatology
362:Dermatology: 2-Volume Set
204:Urinary system evaluation
1208:Happle R (August 2017).
516:"Becker nevus syndrome"
333:Silver–Russell syndrome
198:keratin-producing cells
172:embryologic development
99:Becker's nevus syndrome
392:Gender and Dermatology
117:
109:
1548:Pediatric Dermatology
1167:Pediatric Dermatology
1016:Pediatric Dermatology
640:Surgical Case Reports
572:10.1007/s004390050521
132:supernumerary breasts
115:
107:
88:Supernumerary nipples
471:Dermatologic Therapy
364:. St. Louis: Mosby.
258:intense pulsed light
1659:10.1007/BF02768276
441:10.5070/D36ZJ1R2TP
238:androgen receptors
142:Signs and symptoms
118:
110:
1097:978-1-4511-1342-6
982:Pediatric surgery
943:978-0-323-65382-4
894:978-0-323-51187-2
856:978-0-7020-2774-1
807:978-0-07-183778-1
484:10.1111/dth.15548
409:978-3-319-72156-9
371:978-1-4160-2999-1
230:hyperpigmentation
223:renal ultrasounds
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27:Medical condition
16:(Redirected from
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1610:(5): 349–352.
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1554:(5): 571–574.
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1457:
1430:(3): 197–204.
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1395:(6): 619–620.
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1355:(1): 101–104.
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1316:"Renal Cancer"
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1173:(5): 373–375.
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560:Human Genetics
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41:SNUB syndrome
40:
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18:SNUB syndrome
1769:(1): 88–89.
1766:
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234:dermabrasion
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82:
1473:(1): 9–13.
250:electrology
191:Skin biopsy
66:Usual onset
51:Dermatology
38:Other names
1797:Categories
1734:(1): 161.
1333:2022-07-26
1320:StatPearls
1300:2022-07-26
952:1250272609
903:1003323341
816:1055569130
740:2022-07-26
646:(1): 203.
620:2022-07-26
607:StatPearls
344:References
210:Urinalysis
176:beta-actin
92:milk lines
1808:Syndromes
1586:205678960
1195:222103010
1152:221814643
1106:732776409
1001:778785699
960:cite book
911:cite book
865:460904325
824:cite book
501:248503767
246:flutamide
216:Treatment
182:Diagnosis
152:scoliosis
127:histology
74:Treatment
69:Childhood
47:Specialty
1675:23603999
1632:22076862
1578:22471889
1533:33159249
1495:27982072
1487:17173566
1452:19767644
1444:25782676
1328:32644401
1277:28347698
1236:28625464
1071:78029034
1044:29631671
776:15583590
708:12769398
672:34495428
615:30521275
588:12213995
542:20676475
493:35502558
449:23374946
435:(1): 4.
327:See also
57:Symptoms
1783:8646751
1748:6848716
1713:3303914
1667:8034421
1624:8734657
1409:2346143
1369:8722995
1187:9336809
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166:Causes
1671:S2CID
1628:S2CID
1582:S2CID
1491:S2CID
1448:S2CID
1191:S2CID
1148:S2CID
1067:S2CID
1040:S2CID
696:Cutis
584:S2CID
497:S2CID
1779:PMID
1744:PMID
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1140:PMID
1102:OCLC
1092:ISBN
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997:OCLC
987:ISBN
966:link
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938:ISBN
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889:ISBN
861:OCLC
851:ISBN
830:link
812:OCLC
802:ISBN
772:PMID
704:PMID
668:PMID
611:PMID
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538:PMID
489:PMID
445:PMID
404:ISBN
366:ISBN
256:and
1771:doi
1736:doi
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1564:hdl
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568:doi
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