Leukemia is a life-threatening disease that involves excessive replication of blood cells with defective function. It is a type of blood cancer that compromises the normal function of the cardiovascular system, the clotting cascade, and much more.
These clotting problems and blood function issues make patients with leukemia more susceptible to various types of infections, rashes, and bruises. We will study them separately in this article giving you relevant leukemia rash pictures to help you recognize them as warning signs of this disease.
Rashes, bruises, and other skin manifestations of leukemia
Among rashes and bruises of leukemia, we should differentiate those caused by hemorrhage in the skin and those caused by infections, allergies, and inflammatory processes.
Petechiae
These are the most common hemorrhagic manifestations of leukemia. Petechiae are red spots throughout the skin or located in a certain area. They are caused by a dysfunction in the clotting system because new cells coming out of the bone marrow are immature and not functional. You can recognize them because they are bright red, round, small, and flat.
Purpura
When your bleeding problems have become more severe, petechiae join together in more extensive areas called purpura. Purpura may look either reddish or purple and are usually associated with trauma or very severe alterations in the blood platelet count. This is still an early manifestation of leukemia but may also appear in patients with advanced disease.
Ecchymoses
The most severe hemorrhagic manifestation of leukemia is clinically named as ecchymoses. We may recognize the term as a bruise, a large area that looks either purple, red, or yellowish, depending on the evolution of the lesion. This results from a severe hemorrhage under your skin and is usually triggered by a major trauma in healthy patients, or spontaneously in leukemia patients.
Vasculitis
The termination “itis” means inflammation, and vasculitis is vascular inflammation or inflammation of the blood vessels. Vasculitis is manifested in the skin in various ways. Patients may have petechiae or smaller regions of purpura in the skin, usually located around the affected blood vessels and acquiring the structure of a network with various branches meeting the original road of the blood vessels.
Folliculitis
Another type of inflammatory lesion in the skin is called folliculitis, and it is inflammation of the hair follicles. This type of inflammation is usually triggered by an overgrowth of normal microbiota of the skin that colonizes the area in a way that would not be possible with an intact immune system.
Fungal infections
Among inflammatory manifestations in the skin, patients with leukemia would also have patches in the skin that turn out to be fungal infections. They usually look whitish, pale, or pink, and are commonly located in the upper extremities, lower extremities, and neck.
Allergic reactions
The immune system of patients with leukemia is severely affected by the disease. Another common skin rash in leukemia is associated with allergic reactions to environmental allergens or medications. It usually looks similar to petechiae, but the lesions are often raised with blurred margins.
Leukemia cutis
In some cases, leukemia patients may also have an immune type of rash that is not caused by allergies or hemorrhage. Instead, it is an infiltration of neoplastic leukocytes in the dermis or the epidermis. These clusters of leukocytes look red or brownish, and will only improve as patients go through their leukemia treatment.
Learn more about Leukemia Cutis; Skin Lesions & Treatment Options.
Chemotherapy rash
Treatment of leukemia is meant to improve the prognosis of the patient, but it has several side effects your doctor will need to talk about. One of them is chemotherapy rash, a skin manifestation showing up in various parts of the body which may be associated with stinging, or skin tenderness.
References
Chandran, R., Hakki, M., & Spurgeon, S. (2012). Infections in leukemia. Sepsis-An Ongoing and Significant Challenge.
Betz, B. L., & Hess, J. L. (2010). Acute myeloid leukemia diagnosis in the 21st century. Archives of pathology & laboratory medicine, 134(10), 1427-1433.
Creutzig, U., van den Heuvel-Eibrink, M. M., Gibson, B., Dworzak, M. N., Adachi, S., de Bont, E., … & Lehrnbecher, T. (2012). Diagnosis and management of acute myeloid leukemia in children and adolescents: recommendations from an international expert panel. Blood, The Journal of the American Society of Hematology, 120(16), 3187-3205.