VEGFA and Abnormality of the skin: Polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes (POEMS) syndrome, is a rare multisystemic disease secondary to a plasma cell dyscrasia [1], the diagnosis of POEMS syndrome do not require the presentation of all these symptoms, but many other clinical criteria are included in the diagnosis of POEMS, such as castleman disease, sclerotic bone lesions, vascular endothelial growth factor(VEGF) elevation, extravascular volume overload, papilledema, thrombocytosis/polycythemia, etc.[2].