The case of a patient with POEMS syndrome is presented. The characteristic features of the disorder were associated with the apparently unique and undescribed findings of multiple seborrheic keratosis, ichthyosis, livedo reticularis, and vasculitis, combined with IgM/IgG cryoglobulinemia. Analysis of the cryoprecipitate revealed monoclonal IgM, with kappa light chains. Six years later an immunoblastic lymphoma developed. Notably, the paraneoplastic cutaneous signs were present 6 years before the development of the immunoblastic lymphoma.