Isolated Piloleiomyoma Presenting as a Keloid Scar: A Case Report

Piloleiomyomas are uncommon benign tumors that originate from the arrector pili muscle and can resemble other skin lesions, such as keloids. We report the case of a 32-year-old female who presented with a solitary, painful, erythematous nodule on the extensor surface of the right arm, evolving over three years without preceding trauma. Initially misdiagnosed as a keloid and unresponsive to corticosteroid injections, the lesion was surgically excised, and histological and immunohistochemical analysis confirmed a piloleiomyoma. Postoperative recovery was favorable, with no recurrence at three months. This case highlights the diagnostic challenge posed by isolated piloleiomyomas and the importance of histological confirmation in atypical or treatment-resistant lesions resembling keloids.