A twenty-six-year-old woman came to us because for the past ten years she had had the strangest eruption. Her skin would raise up in waves of rope-like lesions, which were intensely itchy and at times burning. Through the years thousands of these waves had passed over her skin, which left it darkly pigmented. Only her face was clear. High-dose cortisone had been the only way to suppress the waves and the itch.

Even more impressive than this patterned eruption were her massively enlarged breasts. As she sat, we saw them extending down to rest on her thighs. They appeared to be about 20 pounds each in size. She told us that they had never stopped growing.

We knew her skin disease was erythema annulare centrifugum, the result of an immune response. We had seen it in patients with internal cancer, and we had seen it as a result of fungal or yeast infections. But why in this patient? And why were her breasts so enormous?

We hospitalized her and later studied her for months. She had no endocrine disorders, her menses were normal, and no lymphoma or other tumor could be found. Tests showed she was not allergic to any fungi, but she did have a positive L.E. test for lupus erythematosus and a large number of eosinophils (32%) in her blood. The latter spoke to the presence of an allergic reaction, and the former to a sensitization to her own tissues, an autoimmune process.