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October 1979

Atypical Spider Nevi Distribution in Liver Disease

Arch Intern Med. 1979;139(10):1193. doi:10.1001/archinte.1979.03630470101034

To the Editor.—  A variety of cutaneous features are seen in liver disease of which the commonest, though not exclusive for liver disease, is the spider nevus. The face, neck, upper part of the thorax, and arms are the usual sites of occurrence. Our patient had florid spider nevi in thighs and knees, atypical sites of occurrence (Figure).

Report of a Case.—  A 44-year-old woman was admitted to the Gastroenterology Service for management of decompensated chronic alcoholic liver disease. Results of physical examination showed intense jaundice; she was fully conscious without asterixis. Florid spider nevi were noticed in the chest, back, shoulders, arms, and both thighs, as well as the knees. She had massive hepatomegaly, ascites, and bilateral leg edema. Laboratory studies disclosed the following values: WBC, 12,000/ cu mm; hematocrit, 34%; mean corpuscular volume, 100/cu μ; hepatitis-associated antigen, negative; bilirubin, 22.9 mg/dL; SGOT, 136 units; SGPT, 137 units; and