# Multiple Cutaneous Leiomyomas of the Shoulder: Investigating Chronic Pain and Reed’s Syndrome Association

## TL;DR

A case report describes a man with multiple painful shoulder nodules diagnosed as cutaneous leiomyomas, highlighting the need to consider this condition and its possible association with Reed’s syndrome.

## Contribution

This case emphasizes the diagnostic importance of cutaneous leiomyomas and their potential link to Reed’s syndrome.

## Key findings

- Cutaneous leiomyomas were confirmed via biopsy showing spindle cells and cigar-shaped nuclei.
- The patient experienced paroxysmal pain worsened by cold and pressure.
- Treatment included nifedipine and hyoscine hydrobromide for pain management.

## Abstract

Cutaneous leiomyomas are rare benign tumors originating from the arrector pili muscles, often presenting as firm, painful nodules. In this report, we describe a man in his 40s presenting with multiple progressively enlarging painful nodules on the right shoulder first noticed about five years ago. The pain was described to be paroxysmal, worsened by cold exposure and physical pressure, and described as burning and aching. A 4-mm punch biopsy confirmed the diagnosis of multiple cutaneous leiomyomas, showing fascicles of spindle cells and elongated cigar-shaped nuclei in a palisading pattern. The patient was treated with oral nifedipine for pain control, with topical hyoscine hydrobromide (9%) recommended if symptoms persisted. He was advised to follow up for worsening pain and screening for potential Reed’s syndrome. Here, we emphasize the importance of considering cutaneous leiomyoma in the differential diagnosis of painful dermal nodules and the significance of evaluating for possible syndromic associations.