Dysproteinemic purpura is a more or less chronic condition characterized by purpura and by a serum protein pattern which is abnormal qualitatively, quantitatively, or both. Three types of this condition have been recognized.
In 1943 "purpura hyperglobulinemica" was described by Waldenström1; in his patients purpura of the legs of a chronic, recurrent type was accompanied by an increase in serum γ-globulin and elevated sedimentation rate without definite, recognizable systemic disease. Subsequently, macroglobulinemia of Waldenström2,3 in 1944 and cryoglobulinemia of Lerner and Watson4 in 1947 were recognized as distinct dysproteinemic syndromes with hyperglobulinemia. Lerner and Watson stated that purpura cryoglobulinemica could be considered a special type of purpura hyperglobulinemica of Waldenström. In this paper "dysproteinemic purpura of the hypergammaglobulinemic type" will be used to designate the original syndrome of "purpura hyperglobulinemica of Waldenström."*
Although a peculiar, hyperpigmented purpura of the legs is the