Dee Anna Glaser

Zosteriform multiple leiomyomas

ously been reported as zosteriform.4 The most common presentation is red-brown nodules on the extensor extremities, but they also can occur on the trunk, neck, and even the face.1-3,5,6 These lesions are often sensitive to cold or touch, but pain can also be spontaneous.1-3,5,8-10 The usual course is for new lesions to continue to occur.1,3 Autosomal dominant inheritance of multiple piloleiomyomas has been described.5 Several conditions are associated with piloleiomyomas. Our patient probably has familial leiomyomatosis cutis et uteri, also known as Reeds syndrome.3,6,11 The typical family history for Reeds syndrome is several women with early hysterectomies.6 The inheritance pattern is autosomal dominant with incomplete penetrance.11 Women in these families may have multiple cutaneous leiomyomas. Approximately 50% have uterine leiomyomas, compared with about a 10% incidence in the general population of women in the same age group.1,6 Women with multiple cutaneous leiomyomas need periodic gynecologic evaluation.5,6,11 If uterine leiomyomas are present, the patient should be informed that a hysterectomy may be necessary at some point.5,11 For some women, this information can help with family planning. Leiomyosarcoma has been reported to arise within uterine leiomyoma, necessitating Cutaneous piloleiomyomas are benign, often painful, smooth muscle tumors that usually present as red-brown nodules on the extensor extremities.1-5 They can be solitary, but are multiple in 80% of patients.3,6 Multiple lesions may be grouped or widespread.3,4 We describe a 45-yearold woman with multiple painful piloleiomyomas in a zosteriform pattern on her left flank. To our knowledge, zosteriform leiomyoma cutis has not been previously reported.

Surgical Pearl: Repair of split or deformed ear lobe with a tongue depressor blade for stabilization during surgery

From the Department of Dermatology, St. Louis University Health Sciences Center. Reprint requests: Dee Anna Glaser, MD, Assistant Professor of Dermatology, Department of Dermatology, St. Louis University Health Sciences Center, 1402 S. Grand Blvd., St. Louis, MO 63104. J Am Acad Dermatol 1998;38:990-1. Copyright