We report a case of a 65-year-old marathon runner who presented with painful plaques, which were worse in cold weather and  progressed to ulceration. A punch biopsy revealed vascular endothelial hyperplasia and an appearance consistent with reactive angioendotheliomatosis (RAE), a rare, but benign disorder of the skin.  Subsequent  investigations  resulted  in  the  diagnosis  of  type  I cryoglobulinemia; the  lesions  resolved  completely  following  treatment  of the underlying disorder with lenalidomide.