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July 2009

Multiple Tender Papules in a 48-Year-Old Man—Diagnosis

Author Affiliations
 

MARY S.STONEMD

 

SOONBAHRAMIMDCARRIE ANN R.CUSACKMDSENAIT W.DYSONMDMOLLY A.HINSHAWMDVINCENTLIUMD

Arch Dermatol. 2009;145(7):829-834. doi:10.1001/archdermatol.2009.143-b

Histopathologic examination (Figures 2 and 3) revealed a circumscribed nodular arrangement of interlacing fascicles of smooth muscle bundles in the dermis. The tumor cells were characterized by blunt-ended nuclei, perinuclear vacuoles, and abundant eosinophilic cytoplasm. No mitotic figures or pleomorphism were identified. These findings are diagnostic for a dermal pilar leiomyoma. The occurrence of similar skin lesions in 2 of his male family members prompted us to consider the diagnosis of multiple leiomyomatosis. The patient was referred for abdominal ultrasonography and computed tomography of the abdomen and pelvis to rule out occult renal malignancy associated with this syndrome. We also advised his family members to undergo screening.

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