Atypical piloleiomyoma of the face presenting with central ulceration

Piloleimyoma is a type of cutaneous leiomyoma arising from arrectores pilorum. It can present as either a solitary nodule or multiple lesions. Usually it is localized on the extremities, but can also occur on trunk, neck area and face. Lesions are usually cold, ulcerated and spontaneously painful. Herein we report a case of piloleiomyoma with cytological atypia that was painless despite the presence of central ulceration.