|Year : 1992 | Volume
| Issue : 3 | Page : 190-191
Leiomyoma cutis - A report of 3 cases
PVS Prasad, L Padmavathy, K Prasanna, Ra Lakshmana
Source of Support: None, Conflict of Interest: None
A report of 3 women with painful and tender papules and plaques on the breast is presented here. In addition to the involvement of the skin over the breast, 2 patients also had skin lesions on the thigh and back. The histopathology was consistent with Leiomyoma cutis. Two patients responded well to Nifedipine.
Keywords: Leiomyoma cutis, Nifedipine
|How to cite this article:|
Prasad P, Padmavathy L, Prasanna K, Lakshmana R a. Leiomyoma cutis - A report of 3 cases. Indian J Dermatol Venereol Leprol 1992;58:190-1
|How to cite this URL:|
Prasad P, Padmavathy L, Prasanna K, Lakshmana R a. Leiomyoma cutis - A report of 3 cases. Indian J Dermatol Venereol Leprol [serial online] 1992 [cited 2020 Feb 29];58:190-1. Available from: http://www.ijdvl.com/text.asp?1992/58/3/190/3791
| Introduction|| |
Leiomyoma cutis is a rare benign painful skin tumour characterised by hyperplasia of smooth muscle elements found in the skin. Besnier in 1880 classified these tumors as solitary and multiple.  Multiple lesions occur more commonly in men. The diagnostic hallmark of this tumour is the pain which may be provoked by physical or emotional factors. The therapy of this condition largely consists of surgical excision. Meprobamate, nitroglycerine and nifedipine have been advocated to control the pain. 
This report describes 43 cases in which the tumour was seen predominantly over the breast, and their response to medical management.
| Case Reports|| |
Case 1 : A 64-year-odd lady reported with a pruritic swelling on the left breast of 20 years duration. There was no history of antecedent trauma. Examination revealed a large dull erythematous firm arciform plaque of 14 x 6 cms on the lower half of the left breast [Figure - 1]. The lesion was attached to the skin but was freely mobile. On the left thigh there was a linear plaque of 5 x 0.5 cms and another smaller papule of 0.5 x 0.5 cms on the left scapular margin.
Case 2 : A 70-year-old lady was seen with painful skin lesions on the right breast and back for 6 months. There were 4 well defined, dull erythematous plaques of 5 x 4 cms size on the lower half of the right breast [Figure - 2]. She had two similar plaques on the upper back.
Case 3 : A 30-year-old lady reported with a painful swelling on the left breast of 2 years duration. There was a tender plaque of 3 x 2 cms size on the the lower outer quadrant of the left breast.
There was no family history of similar lesions in any of these patients. One patient had mild hypertension. Skin biopsy in all the patients revealed an atrophic epidermis. A mass of well differentiated smooth muscle bundles intersecting in an orderly fashion was seen in the dermis. These cells were seen blending with the surrounding dermal collagen and the tumour was separated from the overlying epidermis by a grenz zone [Figure - 3]. Van Gieson stain confirmed the smooth muscle nature of the cells.
| Comments|| |
Multiple piloleiomyomas are the most common type of leiomyomas. In our study 2 patients reported within 2 years of onset of the painful lesions whereas 1 patient visited after 20 years. Keloid or Morphoeic type of basal cell carcinoma was entertained as an alternative diagnosis in this patient. Even though piloleiomyomas are commonly reported in males,  all our patients were females. Another uncommon feature in those patients was the site of the lesions. One patient had the lesion exclusively on the breast, whereas the other 2 showed papules in addition, on the trunk and lower limbs. There is only 1 earlier report from India of piloleiomyoma on the breast. sub All the patients were treated with oral Nifedipine 10 mg bid. Two patients noticed considerable decrease of pain and tenderness. One patient who did not respond satisfactorily was given Meprobamate and is under observation. Nifedipine, acting as a calcium channel blocker, relieves the pain by relaxing the smooth muscles. 
| References|| |
|1.||Shah RN, Marquis L, Mehta TK. Leiomyoma cutis. Ind J Dermatol Venereol Leprol 1973; 39: 172-6. |
|2.||Shelley WB, Shelley ED. Advanced Dermatologic therapy. Philadelphia: WB Saunders, 1987; 299. |
|3.||Mohan BG, Deshpande SG, Anil HP, et al. Multiple pilolelomyomas. Ind J Dermatol Venereol Leprol 1989; 86: 45-6. |
|4.||Pai GS, Pai PK. Bilateral symmetrical piloleiomyoms. J Ind Med Assoc 1988; 86: 45-6. [PUBMED] |
|5.||Arnold HL, Odom RB, James WDI. Dermal and Subcutaneous tumours. In: Andrews' Diseases of the Skin Clinical Dermatology, 8th Ed, Philadelphia: WB Saunders Company, 1990; 739. |
[Figure - 1], [Figure - 2], [Figure - 3]
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