Cutaneous manifestations in patients with POEMS syndrome

Rachel Y N Miest, Nneka I. Comfere, Angela Dispenzieri, Christine M. Lohse, Rokea A. el-Azhary

Research output: Contribution to journalArticle

16 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)1349-1356
Number of pages8
JournalInternational Journal of Dermatology
Volume52
Issue number11
DOIs
StatePublished - Nov 2013

Fingerprint

POEMS Syndrome
Skin Manifestations
Skin
Paraproteinemias
Hypertrichosis
Hyperpigmentation
Raynaud Disease
Respiratory Function Tests
Hyperemia
Erythema
Hemangioma
Nails
Medical Records
Blood Vessels
Immunoglobulin G
Databases

ASJC Scopus subject areas

  • Dermatology

Cite this

Cutaneous manifestations in patients with POEMS syndrome. / Miest, Rachel Y N; Comfere, Nneka I.; Dispenzieri, Angela; Lohse, Christine M.; el-Azhary, Rokea A.

In: International Journal of Dermatology, Vol. 52, No. 11, 11.2013, p. 1349-1356.

Research output: Contribution to journalArticle

Miest, Rachel Y N ; Comfere, Nneka I. ; Dispenzieri, Angela ; Lohse, Christine M. ; el-Azhary, Rokea A. / Cutaneous manifestations in patients with POEMS syndrome. In: International Journal of Dermatology. 2013 ; Vol. 52, No. 11. pp. 1349-1356.
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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.",
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N2 - 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.

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