title: Cutaneous manifestations in patients with POEMS syndrome.
abstract: 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.
authors.affiliation: Department of Dermatology, Mayo Clinic, RochesterDepartment of Laboratory Medicine and Pathology, Mayo Clinic, RochesterDivision of Hematology, Mayo Clinic, RochesterDivision of Clinical Biochemistry and Immunology, Mayo Clinic, RochesterDivision of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA.
authors.forename: Rachel Y N
authors.initials: RY
authors.lastname: Miest
authors.forename: Nneka I
authors.initials: NI
authors.lastname: Comfere
authors.forename: Angela
authors.initials: A
authors.lastname: Dispenzieri
authors.forename: Christine M
authors.initials: CM
authors.lastname: Lohse
authors.forename: Rokea A
authors.initials: RA
authors.lastname: el-Azhary
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006391:Hemangioma / Q000453:epidemiology*; D006801:Humans; D017495:Hyperpigmentation / Q000453:epidemiology*; D006983:Hypertrichosis / Q000453:epidemiology*; D017496:Hypopigmentation / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009260:Nail Diseases / Q000151:congenital / Q000453:epidemiology; D010004:Osteoarthropathy, Primary Hypertrophic / Q000453:epidemiology; D016878:POEMS Syndrome / Q000175:diagnosis*; D015995:Prevalence; D017445:Skin Diseases, Vascular / Q000453:epidemiology*; D012878:Skin Neoplasms / Q000453:epidemiology*; D055815:Young Adult