Kohlmeier reported the first case of this disease in 1941.1 He regarded it as intestinal thromboangiitis obliterans with skin lesions. In 1942, Degos, Delort, and Tricot reported a second case2 and interpreted it as a new disease entity for which Degos subsequently coined the name "malignant atrophic papulosis." To date about nine cases have come to the attention of European workers. The case reported here is apparently the first case from the United States. Report of a Case History.— A 25-year-old Negro man was admitted to the Dermatology Service of John Sealy Hospital on May 19, 1959, with an asymptomatic papular eruption of six months' duration. The lesions had appeared first on the chest and gradually spread to the abdomen, back, extremities, and neck. Four months prior to admission he had developed recurrent episodes of knife-like pain just to the left of the umbilicus, which had become progressively