Reversal of skin changes in smoldering myeloma with clinical presentation of POEMS syndrome with a lenalidomide-based regimen
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POEMS (Takatsuki or Crow-Fukase syndrome), the acronym for polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes, is a rare multi systemic disorder . It affects men more often than women and usually presents in the 6th decade of life. Skin changes are prominent, with hyperpigmentation being the most frequent alteration . Sclerodermoid skin changes are also very common, and white nails (leukonychia) are characteristic of the disease. Cutaneous angiomas can be present as well as vasculitis, hypertrichosis, and acrocyanosis. Hepatomegaly, splenomegaly, and/or enlarged lymph nodes can also be seen. Hypothyroidism, adrenal insufficiency, and diabetes mellitus represent the most common endocrine system–related disorders. Usually a monoclonal band is seen in serum protein electrophoresis; however, the number of plasma cells that infiltrate the bone marrow can be only slightly elevated. The rarity of the disease delays the diagnosis .
Compliance with ethical standards
All procedures performed in this manuscript were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Written informed consent was obtained from the individual participant described herein to be included in this study.
Conflict of interest
The authors declare that they have no conflict of interest.