CD40LG and Abnormality of the skin: These include amyloid light-chain (AL) amyloidosis (typically presenting with renal or cardiac involvement), cryoglobulinemia (often associated with vasculitic features and cold-induced symptoms), POEMS (Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal protein, and Skin changes) syndrome, increased vascular endothelial growth factor (VEGF) levels, or CANOMAD (Chronic Ataxic Neuropathy, Ophthalmoplegia, IgM M paraprotein, Cold Agglutinins, and Disialosyl antibodies) [15,16].