Topical Diltiazem in the Management of Cutaneous Leiomyoma-Associated Pain: Evaluation With a Cold-Provocation Test

Australas J Dermatol. 2026 Jun;67(4):237-240. doi: 10.1111/ajd.70060. Epub 2026 Feb 9.

Abstract

Cutaneous leiomyomas can cause severe pain that may be spontaneous or stimulus-evoked, and is commonly exacerbated by cold exposure, mechanical pressure/touch, or stress. We report a patient with genetically confirmed hereditary leiomyomatosis and renal cell cancer (HLRCC) in whom topical diltiazem 2% was associated with reduced pain, assessed using a controlled cold-provocation test and validated pain scores. This brief report suggests that topical diltiazem may be a useful symptomatic option and supports further evaluation.

Keywords: fumarate hydratase; administration, topical; calcium channel blockers; diltiazem; hereditary leiomyomatosis and renal cell cancer; leiomyoma; pain management.

Publication types

  • Case Reports

MeSH terms

  • Administration, Topical
  • Calcium Channel Blockers* / administration & dosage
  • Calcium Channel Blockers* / therapeutic use
  • Cold Temperature
  • Diltiazem* / administration & dosage
  • Diltiazem* / therapeutic use
  • Humans
  • Leiomyomatosis* / complications
  • Male
  • Middle Aged
  • Neoplastic Syndromes, Hereditary* / complications
  • Pain* / drug therapy
  • Pain* / etiology
  • Skin Neoplasms* / complications
  • Uterine Neoplasms

Substances

  • Calcium Channel Blockers
  • Diltiazem

Supplementary concepts

  • Hereditary leiomyomatosis and renal cell cancer