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November 1991

Multiple Papules on the Leg

Author Affiliations

University of Virginia Health Sciences Center, Charlottesville

Arch Dermatol. 1991;127(11):1717-1718. doi:10.1001/archderm.1991.01680100117017

REPORT OF A CASE  A 45-year-old white woman was referred to the department of dermatology for evaluation of asymptomatic lesions on her right lower leg. The lesions had first appeared approximately 8 years earlier and had remained unchanged. The patient denied fever or constitutional symptoms. Her other medical problems included rheumatoid arthritis and type II diabetes mellitus.The findings of the physical examination revealed approximately 20 discrete, 4- to 6-mm firm, nontender, erythematous, blanchable papules on the anterolateral aspect of the right leg below the knee (Figs 1 and 2). The surface of the lesions appeared normal. A 4-mm punch skin biopsy specimen was obtained (Figs 3 and 4).What is your diagnosis?

DIAGNOSIS:  Multiple piloleiomyomas.

HISTOPATHOLOGIC FINDINGS  Microscopic sections of a hematoxylin-eosin-stained biopsy specimen revealed a small nonencapsulated dermal tumor composed of interlacing bundles of smooth-muscle fibers with centrally located, thin, long, blunt-edged

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