Conflicts of interest: None.
Cutaneous manifestations in patients with POEMS syndrome
Article first published online: 4 APR 2013
© 2013 The International Society of Dermatology
International Journal of Dermatology
Volume 52, Issue 11, pages 1349–1356, November 2013
How to Cite
Miest, R. Y. N., Comfere, N. I., Dispenzieri, A., Lohse, C. M. and el-Azhary, R. A. (2013), Cutaneous manifestations in patients with POEMS syndrome. International Journal of Dermatology, 52: 1349–1356. doi: 10.1111/j.1365-4632.2012.05648.x
Rachel Miest was a student at Mayo Medical School, College of Medicine, Mayo Clinic, Rochester, MN at the time the manuscript was initially written.
- Issue published online: 25 OCT 2013
- Article first published online: 4 APR 2013
Background Polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes syndrome is a rare multisystem paraneoplastic condition associated with plasma cell dyscrasia.
Methods From our institution’s dysproteinemia database, 107 patients met criteria for polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes syndrome between January 1, 2000, and October 1, 2009. Medical records were reviewed for documented syndrome features at diagnosis. We assessed prevalence of skin findings and associations between dermatologic and other characteristic disease findings.
Results Of the 107 patients, 96 (90%) had a recognized cutaneous manifestation. Hyperpigmentation and hemangioma were most common (47%), followed by hypertrichosis (38%). Vascular skin changes – acrocyanosis (34%), Raynaud phenomenon (20%), hyperemia/erythema (20%), flushing (16%), or rubor (11%) – occurred in 62%; white nails, sclerodermoid changes, and clubbing occurred in 30%, 26%, and 6%, respectively. Mean number of skin findings per patient was 2.9 (median, 3.0; range, 0–7). Presence of cutaneous manifestation was associated with abnormal pulmonary function tests (P < 0.001); immunoglobulin G gammopathy was associated with hyperpigmentation and hypertrichosis. No other significant associations were seen.
Conclusions The high prevalence of skin findings (90%) shows the value of dermatologic evaluation in diagnosis of polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes syndrome. Our data indicate new associations between skin findings and other disease characteristics.