A 24 year old woman with a 3 year history of asthma presented with a disseminated dermatosis manifesting as erythematous, pruritic papules with pain in her metacarpophalangeal and interphalangeal joints. She received unspecified treatment with partial response. Six months later she presented again with erythematous, pruritic papules involving the back, both arms and hands, and right leg. She had edema of the ankles and feet and dyspnea.