Topical Diltiazem in the Management of Cutaneous Leiomyoma-Associated Pain: Evaluation With a Cold-Provocation Test

Cutaneous leiomyomas can cause severe pain that may be spontaneous or stimulus-evoked, and is commonly exacerbated by cold exposure, mechanical pressure/touch, or stress. We report a patient with genetically confirmed hereditary leiomyomatosis and renal cell cancer (HLRCC) in whom topical diltiazem 2% was associated with reduced pain, assessed using a controlled cold-provocation test and validated pain scores. This brief report suggests that topical diltiazem may be a useful symptomatic option and supports further evaluation.