title: Skin manifestations and vascular endothelial growth factor levels in POEMS syndrome: impact of autologous hematopoietic stem cell transplantation.
abstract: OBJECTIVE
  To investigate skin manifestations of the polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome and their correlation with serum vascular endothelial growth factor (s-VEGF-A) levels and to describe the impact of autologous peripheral blood stem cell transplantation (aPBSCT) on these manifestations and the correlation with s-VEGF-A levels.
  
  
  METHODS
  Case series from January 1993 through June 2007.
  
  
  METHODS
  Hospitalized care in Assistance Publique-Hôpitaux de Paris in Pitié-Salpêtrière and Tenon hospitals.
  
  
  METHODS
  Twenty-three patients with POEMS syndrome, 10 of whom were clinically followed up after aPBSCT.
  
  
  METHODS
  Description and distribution of clinical lesions at POEMS syndrome diagnosis, skin evaluation after aPBSCT, and s-VEGF-A levels measured at POEMS syndrome diagnosis and after aPBSCT.
  
  
  RESULTS
  In 21 patients with skin manifestations at POEMS syndrome diagnosis, the most common skin manifestations were hemangiomas (18 patients [86%]), hyperpigmentation (16 [76%]), skin thickening (12 [57%]), acrocyanosis (12 [57%]), hypertrichosis (11 [52%]), acquired facial lipoatrophy (11 [52%]), and white nails (8 [38%]). The median s-VEGF-A level was not different between patients with and without skin manifestations except in those with hypertrichosis (P = .04). After aPBSCT, no significant correlation was observed between s-VEGF-A level decreases and response of skin manifestations, again except for hypertrichosis (P = .007).
  
  
  CONCLUSIONS
  Acquired facial lipoatrophy and livedo should be added to the skin manifestations of POEMS syndrome. Despite a role of s-VEGF-A in various skin manifestations, the impact of s-VEGF-A level decreases on skin outcomes is weak after aPBSCT, mostly resulting in clinical stabilization.
authors.affiliation: Department of Dermatology, University , 75020 Paris, France. stephane.barete@psl.aphp.fr
authors.forename: Stéphane
authors.initials: S
authors.lastname: Barete
authors.forename: Roger
authors.initials: R
authors.lastname: Mouawad
authors.forename: Sylvain
authors.initials: S
authors.lastname: Choquet
authors.forename: Karine
authors.initials: K
authors.lastname: Viala
authors.forename: Véronique
authors.initials: V
authors.lastname: Leblond
authors.forename: Lucile
authors.initials: L
authors.lastname: Musset
authors.forename: Zahir
authors.initials: Z
authors.lastname: Amoura
authors.forename: David
authors.initials: D
authors.lastname: Khayat
authors.forename: Camille
authors.initials: C
authors.lastname: Francès
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016878:POEMS Syndrome / Q000097:blood / Q000473:pathology* / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies; D012867:Skin / Q000378:metabolism / Q000473:pathology*; D014182:Transplantation, Autologous; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*
chemical_list: C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A