Peer Reviewed
Multiple Cutaneous Leiomyomas
A 56-year-old woman presented to clinic for the evaluation of tender nodules that had gradually developed on her back and over her shoulders over several years’ time.
History. She had extensive psoriasis of many years' duration that was well managed by guselkumab for the previous 2 years and mild asthma managed by the occasional use of an albuterol sulfate inhaler. The papules and nodules were flesh colored or red-brown, and they gradually increased in size and number (Figures 1 and 2). Some of the papules were tender to touch and to cold temperatures.
Figure 1. Multiple red-brown papules and nodules are clustered on the left shoulder. The surgical marker illustrates a biopsy site.
Figure 2. Multiple tender, red-brown, and flesh colored papules are clustered on the back. The surgical marker identifies a cluster of symptomatic papules that were later treated by conservative excision.
Diagnostic testing. A biopsy revealed dermal fascicles of spindle cells, many of which had vacuolated cytoplasm (Figures 3 and 4).
Figure 3. A biopsy of the shoulder area reveals fascicles of spindle cells (hematoxylin and eosin-stained sections, original magnification 100x).
Figure 4. Higher power fails to reveal significant nuclear pleomorphism or mitotic figures. Vacuolization of spindle cells is noted (hematoxylin and eosin-stained sections, original magnification 200x).
Answer and discussion on the next page.
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AUTHORS:
Thomas N. Helm, MD1 • Saachvir Singh1 • Kamaljot Singh, MD2
AFFILIATIONS:
1Penn State Milton S. Hershey Medical Center, Hershey, PA
2Buffalo Medical Group and State University of New York at Buffalo, Department of Plastic Surgery, Buffalo, NY
CITATION:
Helm TN, Singh S, Singh K. Multiple cutaneous leiomyomas. Consultant. 2023;63(12):e2. doi:10.25270/con.2023.10.000002
Received February 4, 2023. Accepted June 26, 2023. Published online October 11, 2023.
DISCLOSURES:
The authors report no relevant financial relationships.
ACKNOWLEDGEMENTS:
None.
CORRESPONDENCE:
Thomas N. Helm, MD, Penn State Milton S. Hershey Medical Center, 500 University Drive, PO BOX 850/ HU-14, Hershey, PA 17033 (thelm3@pennstatehealth.psu.edu)