POEMS syndrome, a rare multisystem disease, is a variant of osteosclerotic 
myeloma and is characterized by polyneuropathy, organomegaly, endocrinopathy, 
monoclonal proteins, and skin changes. Presented herein is a case of POEMS 
syndrome with flushing. The flushing was intermittent, involving the face and 
upper third of the trunk, and was associated with hypotension and bronchospasm. 
Final diagnosis was made by biopsy examination of an axillary lymph node, which 
showed angiofollicular hyperplasia that stained strongly and selectively for 
lambda light chains. The patient had most of the typical features of POEMS 
syndrome but was unique in that her most striking finding was carcinoid-like 
flushing. The flushing improved with steroid therapy, as did some of the other 
clinical features of her disease. This case suggests that idiopathic flushing 
can be added to the skin changes observed in POEMS syndrome.