VEGFA and Abnormality of the skin: The etiology of POEMS syndrome remains unclear; recent work suggests that its pathogenesis is related to vascular endothelial growth factor (VEGF), proinflammatory cytokines, matrix metalloproteinases, and human herpes virus 8 infection.[3,4] The acronym “POEMS” summarizes the main clinical manifestations of this syndrome: polyneuropathy (including numbness and tingling in the distal extremities), organomegaly (including hepatosplenomegaly), endocrinopathy, myeloma/monoclonal proteinemia, and skin changes.