If you have leukemia and your damaged white blood cells outnumber healthy ones, you may develop skin symptoms, like rashes, bruising, and mouth sores.
Leukemia is a type of blood cancer that develops in your bone marrow — the place where blood cells are made. It causes your body to make a large number of abnormal white blood cells.
White blood cells normally protect the body against infection. In leukemia, all those damaged white blood cells crowd out healthy blood cells. When this happens, skin symptoms can occur.
In 2018, around
The rate of new diagnoses for leukemia in 2018 was
- 16.5 for non-Hispanic white people
- 11.4 for Black (includes Hispanic) people
- 11.4 for Hispanic (any race) people
- 11.2 for American Indian/Alaska Native (includes Hispanic) people
- 8.8 for Asian/Pacific Islander (includes Hispanic) people
In this article, find out more about the skin symptoms leukemia can cause.
Common skin symptoms with leukemia include:
- acute myeloid leukemia (AML) rash
- mouth sores and swollen gums
- leukemia cutis
- easy bruising and bleeding
- changes in skin color
- other skin infections due to a reduced immune response
Tiny spots called petechiae
One symptom that some people with leukemia might notice is tiny red spots on their skin. These pinpoints of blood are called petechiae. On fair and light skin tones, these may appear as red dots. On darker skin tones, they may be darker than the surrounding skin and less noticeable.
Petechiae usually occur where blood is most likely to accumulate, such as in your:
The spots are caused by tiny broken blood vessels, called capillaries, under the skin. Normally, platelets, the disc-shaped cells in the blood, help your blood clot. But with leukemia, your body does not have enough platelets to seal off the broken blood vessels.
Mouth sores and swollen gums
These changes may happen because of low levels of white blood cells or anemia.
Leukemia cutis refers to various signs that can occur when leukemia affects your skin. It
Symptoms may affect your face, trunk (torso), and extremities and include:
- papules (small raised bumps on skin) and nodules (lumps under the skin) that typically feel firm or rubbery
- plaques (thick patches)
- changes in skin color
- ulcers and blisters, in some cases
A bruise develops when blood vessels under your skin are damaged. People with leukemia are more likely to bruise because their bodies don’t make enough platelets to plug bleeding blood vessels.
Leukemia bruises look like any other kind of bruise, but there tend to be more of them than usual. Additionally, they may show up on unusual areas of your body, such as your back.
The same lack of platelets that makes people bruise also leads to bleeding. People with leukemia may bleed more than they would expect even from a small injury, such as a tiny cut.
They may also notice bleeding from areas where there is no injury, such as their gums or nose. Injuries often bleed more than normal, and the bleeding may be unusually hard to stop.
Change in skin color
Although leukemia can leave dark-colored rashes or bruises on your body, it can also affect your skin color in other ways.
People with leukemia who have fair skin tones may look pale because of anemia. If you have anemia and you have a darker skin tone, you may notice that the mucous membranes in your mouth, nose, or eyes look blueish or gray.
Anemia is a condition in which your body has a low number of red blood cells. Without enough red blood cells to carry oxygen to the body, anemia can cause symptoms such as:
- shortness of breath
If you have leukemia, skin changes can also happen for other reasons, such as an infection or an allergic or sensitivity reaction, for example, to drugs.
When your body cannot produce enough white blood cells, it may become easier for several common infections and other problems to develop. This is because your immune system finds it harder to stop them.
Ringworm and other fungal infections
Leukemia affects your immune system, and this can make it harder to build an immune response against fungal and other infections. The
Some fungal infections can become life threatening. It is essential to follow your doctor’s instructions about how to prevent them and what to do if they happen. Fungal infections can include:
- Ringworm. This is a fungal infection, also called tinea, that can appear on your skin as a circular rash. It is often itchy.
- Nail infections. These can cause your nail to change color, crack, break, and fall off. It may be linked to a fungal infection on your skin.
- Candida. Candida is a fungus that lives on your skin and commonly occurs in the mouth, throat, gut, and vagina. It does not usually cause problems, but it can lead to a rash if your immune system is affected by leukemia.
Many types of fungal infections can affect people with leukemia. It’s best to tell your doctor as soon as you notice any changes so they can help you manage them.
Folliculitis is an infection
Depending on the cause, symptoms can include:
- pustules (small, fluid-filled bumps)
- papules or plaques, in some cases
It can affect the:
Vasculitis is an inflammation of small blood vessels and capillaries. If you have leukemia or another condition that affects the immune system, you may have a higher risk of leukocytoclastic vasculitis.
Symptoms include purple or darker areas on the skin, which may feel different to the touch than the surrounding skin. They can range from
There may be:
- bullae, similar to blisters
- crusted ulcers
There may also be:
- a low grade fever
- a general feeling of being unwell
- body pain
Skin ulceration can occur in some cases. If you notice these types of changes, it is best to speak with your doctor.
- changes in your skin color
Skin changes often appear suddenly, and there may also be a fever. Symptoms may go away without treatment, but if you have a diagnosis of leukemia, it is best to ask your doctor’s advice as you may need treatment.
Allergic reactions to treatment
Some drugs can cause skin rashes.
Morbilliform drug eruption is a common immune reaction to prescription drugs. People with a weakened immune system have a higher risk of developing this type of rash.
A rash may appear 1 to 2 weeks after starting a drug, but it can occur up to a week after finishing the medication. If you start taking the drug again, the rash may come back after 1 to 2 days.
The reaction usually:
- involves papules or flat macules
- changes in your skin color that may become pale with pressure but regain their color on releasing the pressure
- starts on your trunk and spreads to both sides of your body, on the limbs and neck
Skin may become pink to red on any skin tone. The changes in color may be harder to see on darker skin, or the pink or red may be darker.
In most cases, complications don’t arise, and the rash goes away after stopping the drug. But it’s important not to stop using any medication without first checking with your doctor.
Chemotherapy, radiation therapy, and other cancer treatments can also cause a rash, dry skin, and other skin changes. Before starting any new treatment, speak with your doctor about what to expect and when to ask for help.
Leukemia has a variety of symptoms, which will depend on the type of leukemia you have. Many of these are caused by a lack of healthy blood cells. In addition to skin symptoms, the
- feeling unusually tired or weak
- feeling dizzy or lightheaded
- difficulty breathing
- frequent infections, including fever and chills
- heavy bleeding during menstruation
- frequent or severe nosebleeds
- bleeding gums
- weight and appetite loss
- night sweats
Leukemia is not the only possible cause of many of these symptoms, but blood tests and other tests can help your doctor confirm or rule out a diagnosis.
Acute lymphocytic leukemia
Other symptoms of acute lymphocytic leukemia (ALL) include:
- abdominal swelling, as cancer cells build up in your liver and spleen
- lymph node swelling, appearing as lumps under your skin, for instance in your underarms, neck, or groin
- bone or joint pain
- a range of other symptoms if leukemia spreads to other areas, such as the lungs or brain
Chronic myeloid leukemia
- weakness and fatigue
- night sweats and fever
- weight loss
- bone pain
- swelling in your spleen, under the left side of your rib cage
- a feeling of fullness in your abdomen, even after eating just a little
- weakness and tiredness
- feeling cold
- dizziness and lightheadedness
- difficulty breathing
- changes in skin color, for instance, darker skin may become duskier and light skin may appear paler
If you have a diagnosis of leukemia, your doctor will tell you what to look out for and what to do if you see symptoms. If leukemia or your treatment has weakened your immune system, it’s best to seek medical advice as soon as any concerns arise. Your healthcare team can help you manage these symptoms.
If you do not have leukemia, it’s worth remembering that rashes and skin changes can happen for many reasons. However, if other signs are causing concern, ask a doctor to check them out. Many skin changes improve with treatment, and it can be a good idea to rule out more serious causes.