Eruptive Spider Nevus—Like Lesions Associated With the Hyperviscosity Syndrome

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