Leukemia Rashes: Why These Skin Problems Occur and What They Look Like

It's always best to see a healthcare professional for any unexplained rash, especially if you have other symptoms.

What is Leukemia Rash?
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People get rashes for many reasons. If you apply a new moisturizer that contains an irritating ingredient, touch poison ivy, or are recovering from a virus, you might very well end up with a rash. Even stress can cause a rash. In rare cases, however, a rash may be a sign of a handful of types of cancer—leukemia being one of them, according to the MD Anderson Cancer Center.

What Is a Leukemia Rash?

There is a range of skin symptoms that can occur due to leukemia, a type of blood cancer that starts in the bone marrow, according to MedlinePlus. Some people might notice tiny red spots on their arms or legs, while others may find bumpy growths, according to the MD Anderson Cancer Center. Leukemia rashes can also occur as a result of some treatments, like chemotherapy.

Still, most people with leukemia don't get a rash, said Felipe Samaniego, MD, professor in the Department of Lymphoma/Myeloma, Division of Cancer Medicine at the University of Texas MD Anderson Cancer Center. Most leukemia symptoms include bruising easily, fever, and weight loss, according to MedlinePlus. But leukemia rashes do occasionally crop up in people with this type of cancer.

What Are the Types of Leukemia Rash?

There are a few different types of leukemia rashes that vary in appearance. The disease itself can cause a leukemia rash, according to the MD Anderson Cancer Center, but so can some cancer treatments and other infections.

The cause of leukemia rashes isn't always clear, but it can be one manifestation of the disease, said Dr. Samaniego. The most likely explanation for a leukemia rash ties back to the underlying problem in this type of blood cancer, which is an overproduction of abnormal white blood cells, according to MedlinePlus.

Petechiae

Often the abundance of white blood cells impedes the bone marrow's ability to make enough red blood cells and platelets (the latter of which are essential for normal blood clotting), according to the American Society of Hematology. If your platelet count is low, you may bleed and bruise more easily, and broken capillaries under your skin can cause petechiae, according to the MD Anderson Cancer Center.

Petechiae isn't technically a rash, but it is a skin disorder that occurs due to leukemia. Petechiae will appear as tiny red dots—per MedlinePlus—or tiny bruises on the feet, arms, legs, or hands. According to the MD Anderson Cancer Center, this is caused by the breakdown of capillaries, which are small blood vessels.

Sweet Syndrome

In other instances, someone can develop a leukemia rash if they have already been diagnosed with leukemia and are being treated with a granulocyte-colony stimulating factor drug. According to the National Organization for Rare Diseases (NORD), that medication can lead to a reaction called Sweet syndrome, which can cause a rash of tender red and bluish-red bumps or lesions to develop suddenly on the body.

Leukemia Cutis

Leukemia cutis is a skin disorder that occurs due to leukemia. According to the MD Anderson Cancer Center, this disorder occurs when white blood cells leave the blood or bone marrow and infiltrate the skin, causing bumps along the skin. Leukemia cutis may also appear as plaques, ulcers, blisters, or discolored lesions, the National Library of Medicine (NLM) says. Roughly 5%-10% of people with leukemia experience this skin disorder. Additionally, 25% to 30% of leukemia cutis cases occur in children who have been diagnosed with congenital leukemia, per the NLM.

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Blastic Plasmacytoid Dendritic Cell Neoplasm (BPDCN)

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a type of leukemia that typically presents as skin lesions. The authors of a May 2019 article published in Cancers noted that skin effects of the disease could present as lesions that look similar to bruises. They are also described as raised pimples or swellings, ranging in size from a few millimeters to several centimeters, the authors said. According to the MD Anderson Cancer Center, this rare disease only affects 500 to 1,000 Americans every year.

Infection

The most common skin-related symptom in people with leukemia is infection. According to the MD Anderson Cancer Center, the infection could be fungal, bacterial, or viral and may need medication to treat. Symptoms of a skin infection vary, per MedlinePlus, but they might include "swelling, redness, pain, pus, and itching" along with rashes.

Rash Due to Treatment

Cancer treatment—including chemotherapy, targeted therapy, and immunotherapy—can cause skin issues in people with leukemia. Per the American Cancer Society (ACS), the rashes can appear across multiple areas of the body (e.g., scalp, neck, upper body) and may be itchy, burning, stinging, or painful. The skin may break down, or an inflammatory reaction could cause skin issues, according to the MD Anderson Cancer Center.

What Is the Treatment?

Treatment for a leukemia rash will depend on what your healthcare professional thinks is causing it. For example, if the rash is a result of cancer treatments, the ACS says remedies might include:

  • Mild soaps, lotions, or moisturizers
  • Oral or topical medications
  • Skin protection (e.g., by wearing loose-fitting clothing)

If the leukemia rash is a result of cancer cells spreading to the skin, the best fix is to treat the cancer itself (often with chemotherapy, immunotherapy, or targeted therapy, according to the MD Anderson Cancer Center). "You treat the cancer, and the rash goes away," said Dr. Samaniego.

If you haven't been diagnosed with leukemia and aren't sure what's causing a mysterious rash, consult a dermatologist.

Is a Rash a Sign of Leukemia?

Most of the time, rashes have nothing to do with leukemia, according to the MD Anderson Cancer Center. If you have a skin condition that looks like a leukemia rash and don't know why, there's no reason to assume it means you have cancer—especially if you don't have any other leukemia symptoms. With that said, you shouldn't ignore it: See a healthcare professional if you experience any of the following symptoms:

  • The rash has spread all over your body (especially if it spreads quickly).
  • The rash is painful.
  • The rash has started to blister.
  • The rash is swollen and warm to the touch.
  • You have a fever with the rash.

The American Academy of Dermatology (AAD) also says to seek medical care if the rash is accompanied by difficulty breathing or if a blistering rash is affecting skin within your mouth, surrounding your eyes, or in your genital area.

A Quick Review

If you have reason to believe you have a leukemia rash, talk to your healthcare professional. A simple blood test can determine if leukemia is a possibility and if other tests, or a referral to an oncologist, is in order.

If you've been diagnosed with blood cancer and developed a leukemia rash, notify your oncologist right away. Your treatment regimen might need to be changed.

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