Background: Treatment of multiple cutaneous piloleiomyomas which are rare, frequently painful, benign tumors originating from the arrector pilorum muscle of hair follicles is difficult. Objective: To determine the efficiency of botulinum toxin type A (BT-A) treatment for pain relief of cutaneous piloleiomyomas. Methods: A patient with multiple painful piloleiomyomas was treated with local injections of 200 units of BT-A. Results: There was a rapid and sustained decrease in pain. Treatment was repeated every 3 months for 2 years with the same efficacy. Conclusion: BT-A may be a promising new treatment option for multiple painful cutaneous piloleiomyomas.
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