A Generalized Multiple Cutaneous Piloleiomyomatosis in a Young Male: Rare Case Report
A 25-year-old unmarried man presented with generalized multiple painful tumors of 8 years duration. Lesions begun as small pea-sized, skin-colored papules over right lower limb. As it was asymptomatic, patient neglected the skin lesions. Gradually, the lesions over the right lower limb increased in size to 4-6 centimeters. For the past 4 years, multiple new lesions started appearing over trunk, left lower limb, and upper limb. Large lesions were painful for touch and cold. No history of ulceration, discharge from the lesions, or systemic complaints. No history of similar complaints in family/first-degree relatives. Birth and developmental history was normal. On examination, multiple soft to firm tumors of varying in size from 5 mm to 5 cms were seen over the entire length of right lower limb [Figures and ]. Few tumors were also seen over left lower limb, upper limb, upper chest, and back []. Tumors were mobile, tender with shiny skin and telengeictasia over surface. Palms and soles were normal. Oral and genital mucosa was normal. Histopathology revealed normal epidermis and dermis showing interweaving bundles of spindle-shaped cells of dermal smooth muscle, which were strongly eosinophilic [Figures and ]. Patient was started on daily oral 20 mg nifedepine. Large tumors of more than 3 centimeters were excised under local anesthesia, as they were very painful and cosmetically disfiguring.