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June 1992

Eruptive Spider Nevus—Like Lesions Associated With the Hyperviscosity Syndrome

Author Affiliations

Division of Dermatology; Division of Hematology Department of Medicine; Department of Pathology Dalhousie University Halifax, Nova Scotia, Canada B3H 4H7

Arch Dermatol. 1992;128(6):860. doi:10.1001/archderm.1992.01680160150033

To the Editor.—  The hyperviscosity syndrome has been associated with various dermatologic manifestations. Among these are Raynaud's phenomenon, livedo reticularis, digital infarcts, peripheral gangrene, and palpable purpura.1 We describe a patient with immunoblastic lymphoma and hyperviscosity syndrome due to overproduction of IgG-k who presented with spider nevus—like lesions.

Report of a Case.—  The patient, a 34-year-old male coal miner, presented in May 1988 complaining of visual disturbances, fatigue, and night sweats of 6 months' duration. His skin eruption started 4 months before admission as nontender, nonpruritic erythematous papules mainly on the face and dorsa of the hands. He drank three or four bottles of wine per week and "moonshine" once a month.On examination, both fundi showed blurred optic disc margins with numerous hemorrhages and exudates and tortuous, dilated vessels with a boxcarlike appearance. A large, nontender, firm nodule was noted in the left upper parasternal area. The liver edge was palpable, soft, and nontender, with an increased span of 16 cm. He had