Angioma serpiginosum typically presents as a small geometric arrangement of red puncta on a macular red to violaceous background, although limited case reports describe more extensive involvement. We describe 2 women with extensive retiform and confluent erythematous patches on the trunk and extremities (Figure 1A [patient 1] and Figure 1B [patient 2]). Of note, both patients stated that the appearance of their lesions worsened with increased cold and improved with warmth exposure.