There are many signs and symptoms of leukemia. Some of the most common symptoms affect the skin. People with leukemia may develop rashes or bruises with no apparent cause, but these rashes may occur for several reasons and have many different appearances. In some cases, a person may believe that they have a fungal or viral rash.
This article discusses the symptoms and causes of rashes and bruising in leukemia, as well as how the two may be managed. Let your oncologist or health care team know if you develop any new symptoms like rashes or bruising.
Leukemia is associated with several different types of rashes and bruises. You may need a doctor’s help to determine which one you are experiencing and to determine the best treatment.
Leukemia that spreads to the skin (known as leukemia cutis) often looks like a rash. Leukemia cutis is most common in people with acute myeloid leukemia (AML or acute myelogenous leukemia). These rashes look like little mounds under the skin. They may be tiny and distinct, or you may seem to have one larger mound under your skin. They can also appear plaque-like, almost as if something is growing on your skin.
Leukemia that affects the skin might also resemble dry skin or eczema (atopic dermatitis), blisters, ulcerated patches, thickened skin, or other conditions. Skin leukemia can range anywhere from almost unnoticeable to incredibly itchy or painful, depending on where symptoms develop and what form they take. The symptoms are most common on the head, trunk, or neck, but can appear anywhere on the body.
Leukemia on the skin has the same causes as leukemia anywhere else on the body. Blood cancer occurs when the bone marrow produces a blood cell that does not function properly. Over time, the dysfunctioning cell multiplies and crowds out healthy white blood cells, red blood cells, and platelets, causing many symptoms, including tumor-like collections of cells that accumulate under the skin and resemble a rash.
Some people diagnosed with leukemia will develop Sweet’s syndrome. A person with Sweet’s syndrome will quickly develop a high fever and a rash. Typically, the rash consists of red or bluish lesions or tender bumps. The rash can occur anywhere, including the legs, arms, trunk, face, and neck. Sometimes, this rash also involves joint pain and can bring on symptoms of arthritis.
Many things can cause Sweet's syndrome. Underlying cancer and leukemia seem to trigger it in some people, although doctors and researchers are not sure why.
Petechiae are tiny, round, red spots on the skin. They may also appear brown or purple, and they usually appear in clusters that resemble a rash. Most petechiae are completely flat with no raised bumps that you can feel. They are also nonblanching, meaning when you press on them, they will not briefly turn white.
Petechiae are caused by bleeding under the skin. They develop when capillaries (the smallest blood vessels) bleed small amounts of blood under the skin. Although petechiae have several causes, in people diagnosed with leukemia, they develop when damaged blood cells do not allow the blood to clot properly. Poor clotting can occur as the result of thrombocytopenia (a low platelet count).
Frequent and easy bruising is one common symptom of leukemia. However, the bruising that results from leukemia is somewhat different from regular bruising. Seek medical treatment if you have bruising that:
Note that bruising from leukemia may or may not be painful.
Bruising with leukemia is not caused by leukemia itself. As with petechiae, it occurs when the cells in the blood are not clotting normally. Poor clotting causes excessive bleeding under and outside of the skin.
Chemotherapy, one of the most common treatments for leukemia, can cause skin rashes anywhere on the body. These rashes may itch, burn, sting, or hurt, or they may not bother you at all. A rash is often an expected side effect of many chemotherapy treatments and is not considered an allergy or allergic reaction, although rashes from allergic reactions are possible.
If you have a rash from chemotherapy that is making you miserable, it’s time to talk to your doctor. There are ways to treat these rashes so that you do not have to suffer.
The first way to treat many of the conditions above, including leukemia cutis, petechiae, and bruising, is to treat the leukemia itself. Until you treat the leukemia, your blood cells will not function normally, so your symptoms may persist.
Usually, treatment for leukemia involves chemotherapy, but other treatment options may involve radiation therapy, a stem cell transplant, and more. Different treatments work better for different types of leukemia. Your doctor will work with you to find the best treatment for you based on the specifics of your body and your condition.
Treating your leukemia should resolve your Sweet’s syndrome. However, treating Sweet’s syndrome usually also involves taking a course of systemic corticosteroids to address the symptoms. The condition may recur or it may resolve itself over time, although that can take weeks or months.
If you have a rash from chemotherapy, talk to your medical team. Depending on the form your rash is taking, your doctors should be able to recommend products that will help alleviate some of the symptoms. Protect the area from heat and cold and stay out of the sun — sun, heat, and cold can make the rash worse.
When living with leukemia, it can be difficult to find people who understand what you’re going through. MyLeukemiaTeam is the social network for people who have been diagnosed with leukemia and their loved ones. Members come together to ask questions, offer support and advice, and share stories with others who understand life with leukemia.
Have you experienced rashes or bruising with leukemia? Share your experience in the comments below or by posting on MyLeukemiaTeam.