Abstract: 【Abstract】 A 58-year-old female patient presented with erythema on the right shoulder and chest for 8 years. The appearance of erythema was concurrent with numbness and weakness in both lower limbs, elevated peripheral blood M protein levels, thyroid dysfunction, and multiple enlarged lymph nodes in the right axilla, leading to a diagnosis of POEMS syndrome. After autologous hematopoietic stem cell transplantation, erythema subsided but recurred 1 year ago prior to this visit. Physical examination revealed a pigeon egg-sized swollen lymph node on the right side of the neck. Skin examination showed patchy erythema on the right shoulder and chest, with clear boundaries and a hard texture. Serum protein electrophoresis revealed an elevated M protein level, and serum immunofixation electrophoresis showed a restricted IgG λ band. In addition, peripheral blood levels of vascular endothelial growth factor were elevated. Computed tomography scan images showed an irregular flaky bone destruction area at the acromion end of the right scapula, which was consistent with the manifestations of bone plasmacytoma. Histopathological examination of the skin tissue in the right shoulder revealed a large number of dilated and proliferative vessels between dermal collagen fibers, and the patient was diagnosed with AESOP syndrome. Lenalidomide combined with dexamethasone chemotherapy was administered. After three cycles of treatment, M protein turned negative, and erythema became darker in color, and decreased in size compared with the skin lesion before treatment.

Key words: POEMS syndrome, Paraneoplastic syndrome, Plasmacytoma, AESOP syndrome, Vascular endothelial growth factors, M protein