Generalized congenital smooth muscle hamartoma presenting with hypertrichosis, excess skin folds, and follicular dimpling

We describe an interesting patient with a diffuse smooth muscle hamartoma who presented with hypertrichosis, increased skin folds, and follicular dimpling. While smooth muscle hamartoma classically presents as a small hairy, skin-colored to hyperpigmented patch or plaque, rare presentations with diffuse involvement or follicular papules have been described. We present our patient and review the literature to highlight the diverse and under recognized manifestations of this benign neoplasm.