Skin Rashes and Leukaemia: What You Need to Know

Introduction:

Rashes on the skin are a common condition that may be caused by a variety of factors. However, it’s important to pay attention to any accompanying symptoms, as they could be an early warning sign of a more significant health issue. In some cases, a skin rash could be an indication of a serious condition like leukaemia, a type of cancer that affects the blood and bone marrow. But don’t panic! With the right information and awareness, you can take steps to identify the signs and seek medical attention if needed.^1,2

Let us explore the relationship between skin rashes and leukaemia and provide you with everything you need to know to stay informed and take control of your health!

Types of Skin Rashes Associated With Cancer

Erythematous Rashes:

Erythematous refers to redness of the skin caused by dilation and increased blood flow in the small blood vessels (capillaries) located near the surface of the skin. An erythematous rash refers to a skin rash that is characterized by redness and inflammation.

They are often red, raised, and itchy rash that can appear on different parts of the body. An erythematous rash is a type of skin rash that can be associated with cancer patients. This rash can also be caused by bacterial infections from S. viridian and C. haemolyticum.^3,4

Eczematous Rash:

Eczematous refers to a skin condition that resembles eczema, which is a group of inflammatory skin disorders characterized by red, itchy, and scaly patches. An eczematous rash refers to a skin rash that looks like eczema. It is typically characterized by red, scaly patches that are often itchy and can become inflamed. In some cases, the rash may also develop blisters or may even become crusty.

An eczematous rash can be a type of skin rash that looks like eczema and can be associated with skin cancer, specifically basal cell carcinoma. This rash may start out looking similar to other skin conditions as dermatitis, psoriasis, or eczema, but it won’t go away on its own like those noncancerous rashes do. As the cancer gets worse, the rash may start to have a dent or pit in the centre and may even start to ooze or bleed.⁵

Cancer Types Associated with Skin Rashes

• Leukaemia cutis: Leukaemia cutis is a condition in which cancerous white blood cells or their early forms infiltrate the skin, causing visible lesions. These lesions can occur before, after, or at the same time as the diagnosis of systemic leukaemia.⁶
• Mycosis fungoides: Mycosis fungoides is a form of blood cancer, specifically a type of lymphoma, that causes malignant cells to travel to the skin. This type of cancer often presents itself as a scaly and itchy rash, with lesions being a common symptom. If left untreated, the rash can progress into tumours, and the malignant cells can spread to other parts of the body.⁷
• Sézary syndrome: It is a type of cancer that affects the skin and blood and is more aggressive than mycosis fungoides. While some patients with Sézary syndrome develop widespread redness, others may experience a red and itchy rash that covers most of their skin, with peeling being a possible symptom.⁸
• Blastic Plasmacytoid Dendritic Cell Neoplasm (BPDCN): BPDCN is a type of blood cancer that is rare and aggressive. It typically appears as lesions on the skin and may also affect the bone marrow and spread throughout the body.⁹

How Skin Rashes Are Diagnosed and Treated in Cancer Patients

Diagnosis

• Clinical evaluation: A doctor or dermatologist may diagnose a skin rash based on a physical examination of the affected area. They may ask about your medical history, the symptoms you’re experiencing, and any recent exposure to allergens, irritants, or infectious agents.
• Skin biopsy: If a skin rash is suspected to be cancer-related, a dermatologist or oncologist will perform a skin biopsy. A skin biopsy is a procedure that involves the removal of a small sample of skin for testing to diagnose a skin lesion. The skin sample is examined under a microscope to determine the presence of skin cancer, various skin conditions, or skin infections.¹⁰
• Laboratory testing: Depending on the suspected cause of the skin rash, laboratory tests may be ordered. This could include blood tests, allergy tests, or cultures of skin lesions to identify bacterial or fungal infections.
• Patch testing: If an allergic reaction is suspected, patch testing may be performed. This involves applying small amounts of potential allergens to the skin and monitoring for any reactions.¹⁴

Treatment

Treatment for cancer-related skin rashes will depend on the type and stage of cancer. Some common types of treatment options for cancer-related skin rashes include:

• Topical creams or ointments
• Oral medications as prescribed by the healthcare provider.
• Cold compresses or soothing baths
• Phototherapy or light therapy

During cancer treatment, it’s essential to take care of your skin. General pointers include:

• Keep the skin clean and dry
• Moisturize with a gentle, fragrance-free moisturizer
• Avoid exposure to extreme temperatures, such as hot water or direct sunlight
• Wear loose, comfortable clothing made from soft fabrics
• Try to avoid the use of harsh soaps or skincare products

It’s normal to experience side effects from cancer treatment, including skin rashes. In most cases, these side effects are temporary and will go away after treatment is complete. However, if you experience severe or prolonged symptoms, it’s important to talk to your doctor. Some normal/expected side effects from cancer treatment may include:

• Skin redness, itching, or dryness
• Peeling, flaking, or blistering skin
• Sensitivity to sunlight
• Changes in skin colour or texture
• Increased risk of infection in the affected area.¹¹

Skin rashes can also be a symptom of these health issues

A skin rash may be a symptom of cancer but it might also be associated with other health issues such as:

• A rash can be caused by contact with certain chemicals in products like elastic, latex, cosmetics, soaps, detergents, and clothing dyes, as well as plants like poison ivy, oak, or sumac.
• Seborrheic dermatitis, which can be aggravated by age, stress, fatigue, weather, oily skin, infrequent shampooing, and alcohol-based lotions, appears as red, scaly patches on the skin or scalp.
• Other common causes of a rash include eczema, psoriasis, impetigo, shingles, and childhood illnesses like chickenpox and measles.
• A rash can also be caused by medicines, insect bites, and medical conditions such as lupus erythematosus, rheumatoid arthritis, Kawasaki disease, and systemic infections.¹²

Also Read: White Patches On Skin: Causes, Symptoms And Home Remedies

Prevention and Self-Care for Skin Rashes

Skin rashes can be avoided by following a few simple steps, such as:

Preventive Measures:

• Avoid contact with known irritants or allergens.
• Wear protective clothing like gloves or long-sleeved shirts.
• Use mild, fragrance-free detergents and soaps.
• Moisturize the skin regularly.
• Avoid extreme temperatures and excessive sweating.
• Eat a healthy, balanced diet.

Self-Care Tips for Skin Rashes:

• Use a cool compress to soothe itching and inflammation.
• Apply topical creams or ointments as directed by a doctor.
• Avoid scratching or picking at the rash.
• Keep the affected area clean and dry.
• Cover the affected area with a bandage or clothing to prevent further irritation.
• Staying hydrated by drinking plenty of water.¹²

It is important to consult with a healthcare provider before attempting any self-care measures, especially if you have a pre-existing medical condition or are taking medications. Additionally, some skin rashes may be a symptom of an underlying medical condition, including cancer, and prompt medical attention may be necessary.

Facts About Skin Rashes Associated With Cancer

Let us see some facts about skin rashes associated with cancer:

• Cancerous skin rashes can persist and worsen over time if left untreated and do not typically resolve on their own without medical intervention.⁵
• BPDCN can develop in an individual of any age but it is most commonly diagnosed in people in their mid-60s, and it affects men in about 75% of cases.¹³

Frequently Asked Questions (FAQs)

References:

1. Can itchy skin be a sign of leukaemia? [Internet]. Leukaemia Care. 2019 [cited 2023May8]. Available from: https://www.leukaemiacare.org.uk/support-and-information/latest-from-leukaemia-care/blog/can-itchy-skin-be-a-sign-of-leukaemia/
2. Leukemia [Internet]. Mayo Clinic. Mayo Foundation for Medical Education and Research; 2022 [cited 2023May8]. Available from: https://www.mayoclinic.org/diseases-conditions/leukemia/symptoms-causes/syc-20374373 
3. Erythema multiforme [Internet]. Erythema Multiforme | Johns Hopkins Medicine. 2019 [cited 2023May8]. Available from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/erythema-multiforme 
4. Kang JH. Febrile illness with skin rashes. Infection & Chemotherapy. 2015Sep;47(3):155. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4607768/#B25
5. Can rashes be a sign of cancer? Moffitt [Internet]. Moffitt Cancer Center. [cited 2023May8]. Available from: https://moffitt.org/taking-care-of-your-health/taking-care-of-your-health-story-archive/can-rashes-be-a-sign-of-cancer 
6. Rao AG, Danturty I. Leukemia cutis. Indian journal of dermatology. 2012 Nov;57(6):504. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3519272/ 
7. Mycosis fungoides: A rash that can be cancer [Internet]. Stanford Health Cae (SHC) – Stanford Medical Center. 2014 [cited 2023May8]. Available from: https://stanfordhealthcare.org/newsroom/news/press-releases/2014/mycosis-fungoides.html# 
8. Skin cancer types: Cutaneous T-cell lymphoma signs & symptoms [Internet]. American Academy of Dermatology. [cited 2023May8]. Available from: https://www.aad.org/public/diseases/skin-cancer/types/common/ctcl/symptoms 
9. Gurbuxani S. Blastic plasmacytoid dendritic cell neoplasm. Waltham (MA): UpTo-Date Inc. 2019. Available from: https://www.uptodate.com/contents/blastic-plasmacytoid-dendritic-cell-neoplasm 
10. Skin biopsy: Medlineplus medical test [Internet]. MedlinePlus. U.S. National Library of Medicine; [cited 2023May8]. Available from: https://medlineplus.gov/lab-tests/skin-biopsy/ 
11. Skin rash: Skin problems: American Cancer Society [Internet]. Skin Problems | American Cancer Society. [cited 2023May8]. Available from: https://www.cancer.org/cancer/managing-cancer/side-effects/hair-skin-nails/skin-rash.html 
12. Rash [Internet]. Pennmedicine.org. [cited 2023May8]. Available from: https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/rash 
13. Facts about blastic plasmacytoid dendritic cell neoplasm (BPDCN) [Internet]. [cited 2023May8]. Available from: https://www.lls.org/sites/default/files/2021-05/FSHP2_BPDCN_FINAL_2019.pdf 
14. Rash evaluation: Medlineplus medical test [Internet]. U.S. National Library of Medicine; [cited 2023 May 12]. Available from: https://medlineplus.gov/lab-tests/rash-evaluation 

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