A 62-year-old woman who had a history of asthma and allergic rhinitis developed bilateral pulmonary infiltrates and marked eosinophilia. A transbronchial biopsy specimen did not help clarify the diagnosis. She later developed erythematous nodules on her feet; results of a biopsy specimen revealed necrotizing extravascular granulomas and marked infiltration of the dermis with eosinophils consistent with a diagnosis of Churg-Strauss syndrome. Skin manifestations are often nonspecific in this syndrome and occur in approximately two thirds of cases.