Glomeruloid hemangioma as late manifestation of POEMS syndrome

Glomeruloid hemangiomas were first described by Chan in 1990 as a cutaneous marker of POEMS syndrome (Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal proteinemia, and Skin changes). POEMS syndrome is a multisystem disease with a significant cutaneous involvement. Among its manifestations, hemangiomas are common, observed in up to one third of the patients, and, although specific, the glomeruloid subtype is very rare. The vascular endothelium growth factor (VEGF) is an angiogenic stimulation factor, which also induces increased systemic vascular permeability. Thus, a scenario of overexpression of VEGF can credibly lead to the assumption of an association between cutaneous hemangiomas and systemic manifestations, implying prognostic and therapeutic considerations and reinforcing the importance of dermatological periodical consultations for these patients. We report the case of a patient in whom glomeruloid hemangiomas marked the recurrence of POEMS syndrome, occurring before the systemic symptoms.