Skin Rashes And Leukemia

The vast and most important organ in the human body is the "skin," which accounts for about 16% of the body weight. It covers the entire body surface and is responsible for several vital functions. Indian Council of Medical Research (ICMR) claims the incidence of leukemia in India is around 3-4 cases per 100,000 people. However, it is mandatory to note that this number may vary depending on the specific region of India and other factors. In 2019, an estimated 69,700 people had acute myeloid leukemia (AML). Today's blog will discuss the relationship between skin rashes and leukemia. We will explore the different symptoms of cancer skin rash that can occur in leukemia and the underlying mechanisms behind developing these skin rashes in leukemia.
 

How Are Leukemia And Skin Rashes Connected? 

Leukemia is one type of cancer that affects the blood and bone marrow. The abnormal growth of white blood cells in leukemia can cause various symptoms, including skin rashes. Skin rashes in leukemia are typically caused by the disruption of normal blood flow and clotting, leading to bleeding under the skin and the formation of tiny red or purple dots known as petechiae.

Skin Symptoms Associated With Leukemia

• Petechiae and purpura
• Easy bleeding and bruising
• Leukemia cutis
• Sweet syndrome
• Mastocytosis
• Mouth sores and pale skin

Petechiae And Purpura

Petechiae are purple spots, small or pinpoint-sized red on the skin (less than 3mm) that occur when capillaries, which are tiny blood vessels, rupture under the skin. Petechiae can show up anywhere on the body, but the lower legs, feet, and ankles are where they are most frequently seen.

Purpura may appear red, purple, or brown (over 3mm). Darker parts of the skin can be harder to find, but it may be easier to see on lighter areas like palms and the soles of the feet. In leukemia, petechiae and purpura can be a sign of thrombocytopenia (low level of blood platelets), a common side effect of leukemia treatment with an increased risk of bleeding and bruising. 

Treatment

• Usage of corticosteroid creams to reduce inflammation
• Blood and platelet transfusion
• Chemotherapy

Leukemia Cutis

Leukemia cutis is a rare condition in which leukemia cells infiltrate the skin, causing skin lesions and other symptoms. It is a type of extramedullary leukemia, meaning the leukemia cells are found outside the bone marrow.
 

Leukemia cutis can occur in any leukemia but is most commonly associated with acute myeloid leukemia (AML) and chronic lymphocytic leukemia. The skin lesions associated with leukemia cutis can take many forms, including nodules, papules, plaques, or patches. The lesions may be single or multiple and can be localized or widespread. Acute myeloid leukemia (AML) rash looks like a purple or red spot on light skin. It is less noticeable in darker skin.
 

Treatment
 

• Chemotherapy
• Radiation therapy
• Stem cell transplant
• Supportive care
   

Easy Bleeding And Bruising 
 

These symptoms occur because leukemia cells can interfere with the normal production of platelets in the bone marrow, which are cells that help the blood clot. Bruising may occur spontaneously or after minor injuries and may appear as small purple or red dots on the skin, like petechiae and purpura. In addition to skin bruising and bleeding, thrombocytopenia can cause bleeding from the gums, nosebleeds, and heavy menstrual bleeding in women.
 

Treatment
 

• Platelet transfusions - To increase the platelet in the bloodstream
• Clotting factor replacement therapy - To help promote blood clotting and prevent bleeding.
• Blood transfusions- To help increase the number of red blood cells in their bloodstream and improve oxygen delivery to tissues.
• Bone marrow transplantation -To treat the underlying leukemia and restore normal blood cell production.
• Other medications, such as desmopressin or antifibrinolytics

Sweet Syndrome
 

Sweet syndrome is thought to occur due to an overactive immune response in which white blood cells attack normal tissues, including the skin. The sweet syndrome may be caused by the leukemia itself or as a side effect of chemotherapy. The skin lesions associated with Sweet syndrome typically appear as red or purple bumps or plaques on the arms, legs, face, or neck. The lesions may be tender and may be accompanied by fever and fatigue.
 

Treatment
 

• Corticosteroids
• Chemotherapy
• Topical treatments
• Supportive care
• Other medications, such as cyclosporine or azathioprine

Mastocytosis
 

This medical condition occurs when there is an abnormal accumulation of mast cells (white blood cells) in various tissues throughout the body, including the skin; excessive accumulation of mast cells can lead to skin lesions, rashes, itching, and other symptoms such as gastrointestinal disturbances, headaches, and bone pain.
 

Treatment
 

• Antihistamines, leukotriene inhibitors, or corticosteroids
• Targeted therapy
• Chemotherapy
• Bone
   

Mouth Sores and Pale Skin

Mouth sores (oral ulcers or mucositis) can occur due to various factors, including the effects of chemotherapy or radiation therapy on the lining of the mouth and gastrointestinal tract and the direct effects of leukemia cells on the tissues. These sores can be awful and may make it hard to eat or drink.
 

Treatment
 

• Topical pain relievers
• Mouthwashes
• Corticosteroids or Antimicrobial drugs
• Good oral hygiene
   

Pale skin (pallor) can occur because of reduced RBC production in the bone marrow. In leukemia, the abnormal growth of white blood cells can crowd out the production of red blood cells, leading to anemia and pale skin.

Treatment
 

• Erythropoietin-stimulating agents (to stimulate the production of red blood cells)
• Blood transfusions
• Iron supplements

"Cancer is a journey, but you walk the road alone. There are places to hold along the way and get better. But you just have to be willing to take it." 

It is important to remember that various other conditions can produce malignant skin rashes, so communicating with a healthcare professional for diagnosis and treatment, as well as discussing the risk of leukaemia with other conditions, is required. Additionally, skin rashes are not always present in leukemia, and the absence of a rash does not necessarily rule out the possibility of leukemia. Close monitoring of symptoms and blood counts may also be necessary to evaluate response to treatment. While leukemia and its associated symptoms can be challenging, staying hopeful and remembering that you are not alone is important. With the right treatment and support, you can continue walking your path and find moments of nourishment and strength along the way.