Unilateral Multi-Segmental Leiomyomas: A Report of Rare Case
A 30-year-old unmarried female presented to us with 15 years history of painful papules and nodules only on right half of the body. These lesions initially appeared on the right upper limb and the shoulder but subsequently developed over the trunk, gluteal region, and the thigh of the same side. Each lesion started as a papule, which gradually increased in size to form a nodule. She also gave history of pain associated with these lesions, especially on exposure to cold and touch. Menstrual history did not reveal any abnormality, and there were no known family members with cutaneous leiomyomas or uterine fibroids. General physical examination was unremarkable. Cutaneous examination revealed multiple tender erythematous papules and nodules [], varying in size from 0.5 cm to 2 cm, distributed in segmental pattern over the upper limb, trunk, and thigh on the right side of the body with sharp limitation in the midline [].\nBased on history and cutaneous examination findings, we considered the differential diagnosis of leiomyomas, angiolipomas, eccrine spiradenomas, and neurofibromas. Routine hematological investigations, blood urea, serum creatinine, and ultrasound examination of the abdomen were within normal limits. HIV serology was negative. Histopathological examination of skin biopsies taken from the arm, trunk, and thigh showed bundles of spindle-shaped cells arranged in an interlacing and whorled pattern with elongated nuclei having rounded ends confirming the diagnosis of piloleiomyoma []. Patient was started on nifedipine 10 mg thrice-daily with significant symptomatic improvement in 3 months.