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Puzzling painful nodules on back: a case report.

Meghana Pendam¹, Bhushan Madke¹, Samyak Ganjre¹

¹Department of Dermatology, Venereology and Leprosy, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Science, Wardha, Maharashtra, India.

The Pan African Medical Journal

|October 26, 2022

Summary

Cutaneous piloleiomyoma, a rare benign skin tumor, typically presents as painful nodules. This case highlights an unusual presentation and effective pain management with amlodipine.

Keywords:

Piloleiomyoma arrector pili muscle calcium channel blocker case report painful skin tumour

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Area of Science:

Dermatology
Oncology

Background:

Cutaneous leiomyomas originate from smooth muscle, including arrector pili muscles, scrotal dartos, and vascular smooth muscle.
Cutaneous piloleiomyoma, derived from arrector pili muscles, is an uncommon benign skin tumor.
These tumors often manifest as solitary or multiple painful nodules, occasionally presenting in diffuse or zosteriform patterns.

Observation:

An unusual case involved multiple tender papulonodular lesions on the right infrascapular region.
Histopathological examination of a nodule revealed a dermal tumor composed of interlacing fascicles of spindle cells.
This histological pattern confirmed the diagnosis of piloleiomyoma.

Findings:

The patient presented with multiple, tender papulonodular lesions.
Histology confirmed the diagnosis of piloleiomyoma, a benign smooth muscle tumor of the skin.
Oral amlodipine was prescribed for symptomatic pain relief.

Implications:

This case expands the clinical presentation spectrum of cutaneous piloleiomyoma.
Amlodipine demonstrates potential as a therapeutic option for managing pain associated with piloleiomyoma.
Further research may explore the efficacy of calcium channel blockers in treating cutaneous leiomyomas.