Abstract

Alterations in the skin may be the first or the most striking manifestation of an internal disease. This fact is exemplified at times by erythema nodosum in sarcoidosis, facial flush in metastatic carcinoid, and xanthomata with hyperpigmentation in biliary cirrhosis. Any list of cutaneous signatures also should include venous stars. These structures, occasionally referred to as venules, varicules, or venous telangiectases, are small, dilated, superficial cutaneous veins. Although venous stars may have great clinical significance, they have received little attention in medical writings. The purpose of this report is to describe 2 patients in whom the appearance of venous stars over the chest constituted the first objective evidence of obstruction of the veins of the superior mediastinum. Report of Cases Case 1.— This 60-year-old man was admitted to the Salt Lake County General Hospital on April 2, 1961, because of hemoptysis of 2 weeks' duration. Four months before admission the

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