In the very rare POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, skin changes), the M-protein is almost always lambda, and through molecular mimicry between monoclonal lambda light chains and some receptors involved in vascular endothelial growth factor (VEGF) secretion, specific lambda light chains induce VEGF hypersecretion and TMA-like glomerular changes [19,20,21]. Here, VEGFA is linked to Abnormality of the skin.