What Are The Different Types Of Skin Conditions Seen In Multiple Myeloma
Multiple myeloma develops in plasma cells, a type of white blood cell that produces proteins called antibodies that tell other cells in your immune system to attack foreign invaders.
Myeloma or treatment for myeloma can cause a variety of skin conditions, including rashes, sores, and bumps. Symptoms can develop due to:
- the accumulation of plasma cells in your skin
- the buildup of abnormal M protein produced by cancer cells
- medication side effects
of plasmacytomas forming at the site of traumatic injury have also been reported.
A plasmacytoma that grows outside of your bone and bone marrow is called an extramedullary plasmacytoma. About 7 percent of people with myeloma have an extramedullary plasmacytoma when they receive their diagnosis, and another 6 to 7 percent develop one later. They tend to develop if you have aggressive or highly progressed myeloma.
Skin plasmacytomas usually present as red bumps or plaques that may form ulcers, or sores on the lining of your stomach or small intestine.
Skin Rashes And Leukemia: What You Need To Know
Skin is the biggest organ we have. As such, it often acts as a type of window into the rest of the body. So, rashes and other skin disorders can be a sign of something else going on inside of you especially when you have cancer. Thats why its wise to pay attention when you notice one, and get it checked out if it doesnt go away on its own.
Rashes and skin conditions that resemble rashes can be a symptom of some types of cancer. They can also be a side effect of the therapies used to treat cancer, or caused by other factors entirely, such as allergic reactions, shingles , and other infections.
Investigation with your health care team will usually provide a clearer picture as to why youve developed a particular rash or skin condition. But its important to remember that not every disturbance on the skin is a rash. And not every skin rash is related to cancer.
Why the word rash is so hard to define
Skin rashes are notoriously hard to define, as they can involve so many different features: itchiness, redness, bumpiness, roughness, scaliness, swelling, and irritation, to name but a few. But not every rash will share the same characteristics, and appearances can vary widely even between early cases and those that are more advanced.
At MD Andersons Leukemia Center, the skin conditions we see most often in our patients fall into one of three major categories.
The rash thats not really a rash: petechiae
Most skin rashes are unrelated to cancer
What Are The Stages Of Multiple Myeloma
There are four stages of multiple myeloma. While many health care professionals use different staging, these are various stages cited by many clinicians:
- Smoldering: multiple myeloma with no symptoms
- Stage I: early disease with little anemia, relatively small amount of M protein and no bone damage
- Stage II: more anemia and M protein as well as bone damage
- Stage III: still more M protein, anemia, as well as signs of kidney damage
Because staging criteria differ according to different medical groups, some clinicians simply define the individual’s multiple myeloma without assigning a stage and simply estimate a prognosis for their patient. In 2013, an international group divided stages into three stages based on two criteria, the concentration of beta-2-microglobulin and serum albumin levels over time, these defined criteria may become widely accepted.
However, each individual is unique and may do better or worse than the prediction based on the various stages.
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Questions To Ask Your Doctor
Itâs always a good idea to bring up concerns and ask questions at your office visits. Put these on your list:
- How can I stay healthy?
- Are there ways to ease my pain?
- What stage is my disease in, and what does it mean for me?
- Does my treatment have side effects?
- Should I get a second opinion?
- Should I join a clinical trial?
What Are Multiple Myeloma Symptoms
Multiple myeloma causes many symptoms, but bone pain often is the first symptom people notice. Other symptoms include:
- Weakness in your arms and legs and/or a sensation of numbness in your arms and legs. Multiple myeloma can affect the bones in your spine, causing them to collapse and press on your spinal cord.
- Having fatigue feeling so tired you cant manage daily activities and feeling weak. These are signs of anemia.
- Nausea and vomiting. This may be a sign of hypercalcemia.
- Not having an appetite and/or feeling thirstier than usual. These may be signs of hypercalcemia.
- Unexplained weight loss.
- Unexplained fever. This may be a symptom of a bacterial infection.
- Bruising or bleeding more easily. This may be a sign abnormal plasma cells prevent your body from producing enough platelets. Platelets help your blood to clot.
- Feeling confused or foggy.
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Treating Skin Problems And Rashes
If you develop any skin problems, remember they can be treated. For simple skin problems, you may be able to treat them on your own at home. It is still a good idea to check with your nurses and oncologist to make sure your treatments are safe for your skin condition.
Dry skin can be treated not only with moisturizers but also with colloidal oatmeal baths and special ointments.
If you start to develop open wounds or peeling skin, be sure to pay special attention to those areas to prevent skin infections. Ensure the skin stays clean and dry, and if needed, use dressing material recommended by your nurses to keep the area covered.
For more serious skin conditions and rashes, your oncologist might order specific treatment or refer you to a dermatologist. There are several medications, both topical and oral, that can be used to treat more serious skin conditions and rashes. Over-the-counter or prescription antibiotics, corticosteroids like dexamethasone and antihistamines may be suggested treatments to heal your skin.
Ice packs are not recommended due to the risk of increasing the damage to already sensitive skin. Make sure to check with your oncologist or dermatologist before using an ice pack.
Another member said they used clobetasol cream for the rashes after belly shots, and it worked very well for me.
Always let your oncologist know about any skin conditions you develop, and ask for their opinion before starting any over-the-counter treatments.
What Causes Itchy Skin In Multiple Myeloma
Cutaneous itching is occasionally caused by treatments for multiple myeloma. Rarely, people with multiple myeloma may also experience itching as a result of complications caused by cancer.
Other risk factors may contribute to itching. It is possible to experience skin itchiness unrelated to multiple myeloma and its treatments when living with cancer. If you have allergies to specific foods or substances, for example, you may develop an itchy allergic rash after coming into contact with them. Other skin conditions, such as eczema, may also cause the skin to itch.
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Causes Of Multiple Myeloma Bone Pain And Lesions
Multiple myeloma can cause osteolytic lesions, or soft spots in the bone, that appear as holes on an X-ray. These osteolytic lesions are painful. They can increase the risk of painful breaks or fractures.
Multiple myeloma can also cause nerve damage or pain when a tumor presses up against a nerve. Tumors can also compress the spinal cord, which can result in back pain and muscle weakness.
According to the Multiple Myeloma Research Foundation, approximately 85 percent of people diagnosed with multiple myeloma experience some degree of bone damage or loss.
What Does A Rash From Hodgkin Lymphoma Look Like
If youre experiencing a skin rash, you may be wondering whats causing it and whether it could be a sign of Hodgkin lymphoma. Although certain other types of lymphoma can cause skin irritation, this symptom is fairly uncommon with Hodgkin lymphoma, which sometimes produces pruritus without a rash. Researchers believe the itchiness is caused by cytokines, which are chemicals released by the bodys immune system in response to lymphoma. Cytokines can irritate nerve endings in the skin, which can in turn cause persistent itching. Many individuals experience this itchiness in their hands, lower legs or feet, while others feel it throughout their entire body. Patients often report that the itching tends to worsen while they are lying in bed at night.
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What Specialties Of Health Care Professionals Treat Multiple Myeloma
Although the patient’s primary care doctor helps to manage the patient’s care, the specialists involved often include an oncologist, hematology pathologist, radiologist, stem cell transplant specialist, and occasionally a surgeon . Researchers like Avet-Loiseau and others are actively seeking better treatments.
Raised Calcium Levels In The Blood
A high level of calcium in the blood can develop in people with multiple myeloma because too much calcium is released from affected bones into the bloodstream.
Symptoms of hypercalcaemia can include:
- constipation
- confusion and drowsiness
You should seek immediate medical help if you have symptoms of hypercalcaemia, as they need quick investigation and treatment.
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What Are Lifestyle And Diet Tips For People With Multiple Myeloma
To stay healthy, lifestyle changes can help individuals with multiple myeloma. Physicians recommend giving up tobacco, reducing alcohol intake, eating better, and getting more exercise. Eating better may be difficult because of changes in your diet and tastes. After multiple myeloma treatments, it can be helpful to eat small meals about two to three hours apart until you feel as if you can eat a larger meal. During treatment, fitness or endurance and muscle strength can decline. For exercise, start slowly by taking short walks or getting involved with an exercise program that gradually increases without pushing the body too hard.
Prevention Is Key: Skin Care Is Skin Health
Skin cancer prevention is a top public health priority for the American Academy of Dermatology Association.
One of the major risk factors for skin cancer is unprotected exposure to the suns UV rays. Therefore, prevention starts by tackling this key risk factor.
You can take action for prevention by doing the following:
- Wear sunscreen! Even better: wear water-resistant sunscreen with an SPF of 30 or higher to uncovered skin.
- Reapply sunscreen every two hours when outdoors! Yes, you read correctly. Applying sunscreen once a day is simply not enough.
- Follow the American Academy of Dermatology comprehensive sun protection plan: seek shade wear protective clothing, including a lightweight, long-sleeved shirt, pants, a wide-brimmed hat, and sunglasses.
- Stay vigilant! HealthTree is all about empowering patients. Know your skin, ask questions, stay informed. Notice a suspicious skin mole or lesion? Schedule a consult.
- Finally, attend your Dermatology check-up. Your Dermatologist is your skins best friend. Let the experts take care of you.
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Does Multiple Myeloma Cause Skin Discoloration
Skin plasmacytomas usually present on lighter skin as red bumps or whitish plaques that may form ulcers. On darker skin , the bumps may appear darker red or purplish in color, and the plaques may have a grayish tone to them.
Some other skin conditions associated with myeloma can cause signs such as ulcers or symptoms such as rashes or redness.
Preventing Skin Problems And Rashes
Ask your oncologist what skin products are the safest and most effective in preventing skin problems. Keep your skin moisturized with non-alcohol-based lotions and creams that are free of fragrances. Your skin should be kept clean with a mild soap, fragrance-free as well. Washing with lukewarm water, not hot, will decrease the risk of drying out or damaging your skin. Check with your oncology team about using deodorants, powders, or perfumes.
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Treatments And Procedures For Multiple Myeloma
Chemotherapy, radiation therapy, bone marrow transplantation, and some medications can cause itchy skin in people with multiple myeloma.
Radiation Therapy
Radiation therapy, also known as radiotherapy, can result in changes, including itching. This is typically accompanied by dry, peeling skin, which may give it the appearance of sunburn.
Chemotherapy
Certain forms of chemotherapy can cause uncomfortable itchiness and dryness. When this happens, the skin may also redden, darken, or peel and take on a rashlike appearance.
Stem Cell Transplants
People with cancer who have undergone allogeneic stem cell transplants commonly develop a condition known as graft-versus-host disease . GVHD occurs when the donors immune cells recognize your body as a foreign invader. The first symptom of GVHD is often an itchy, dry rash on the palms or the soles of the feet.
Medications for Multiple Myeloma
Some medications used in multiple myeloma treatment can cause itchy skin as a side effect. These drugs include corticosteroids and bortezomib .
What Is Multiple Myeloma What Are Plasma Cells
Multiple myeloma definition
Multiple myeloma is a type of cancer of the plasma cells of the bone marrow. Plasma cells are protein-making cells that normally produce the different kinds of antibodies of the disease-fighting immune system. In multiple myeloma, the plasma cells undergo a malignant transformation and become cancerous. These myeloma cells stop making different forms of protein in response to the immune system’s needs and instead start to produce a single abnormal type of protein sometimes termed a monoclonal or M protein. Multiple myeloma plasma cell populations accumulate in the bone marrow, and these collections of cells called plasmacytomas can erode the hard outer shell or cortex of the bone that normally surrounds the marrow. These weakened bones show thinning of the bone, as seen in nonmalignant osteoporosis or what appear to be punched out or lytic bone lesions. These lesions may cause pain and even breaks or fractures of the weakened bones. They may cause other systemic problems listed below. People often refer to multiple myeloma simply as myeloma . The disease usually occurs in people past middle age. However, rarely it can occur in a child.
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What Is The Prognosis For Multiple Myeloma What Is The Survival Rate For Multiple Myeloma
The prognosis of multiple myeloma is variable, depending on the approximate stage and response to therapy. Though there is no cure for the disease, today’s treatments are more effective and less toxic than did many in the past. Multiple myeloma is a focus of active ongoing research. The average survival rate, beginning at the point of first treatment according to the American Cancer Society , based on the stage of the disease is as follows:
- Stage I, 62 months
- Stage II, 44 months
- Stage III, 29 months
However, the ACS suggests that with treatment improvements, current survival rates are likely better. Unfortunately, life expectancy after relapse averages about nine months.
Complications of multiple myeloma may include kidney insufficiency, bleeding disorders, bone problems like pathological fractures, hypercalcemia, and neurological problems .
Real World Evidence In Healthtree Cure Hub
For patients using the Real World Evidence portal called the HealthTree Cure Hub, 699 myeloma patients reported having a secondary cancer, melanoma being 15% of the secondary cancers. To put this into perspective, the incidence rate of melanoma of the skin in the US standard population is .02%, as reported by the American Cancer Society.
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What Is A Haematological Disease
Haematological diseases are a diverse range of conditions affecting the constituents of blood. This includes disorders of the blood cells and cancerous conditions affecting these blood cells. Skin signs of haematological disease described here are helpful in diagnosis and may also cause complications.
Rashes Caused By Skin Lymphoma
Although Hodgkin lymphoma generally doesnt cause a rash, other forms of lymphoma can. For instance, skin lymphomaa type of non-Hodgkin lymphomacan cause skin irritation. There are various types of skin lymphoma, including T-cell skin lymphoma and B-cell skin lymphoma. The most common form of T-cell skin lymphomaaccounting for almost half of all skin lymphoma casesis mycosis fungoides .
Its important to note that although skin lymphoma develops in the skin, its not a type of skin cancer. Whats more, another type of lymphoma that starts elsewhere in the body and then spreads to the skin is not skin lymphoma.
When a rash caused by skin lymphoma is in its early stages, it often presents as small patches of dry, red skin on the torso, buttocks or another area of the body. At this stage, the rash often resembles dermatitis, eczema or psoriasis. Certain areas of skin may also thicken, harden and form plaques that itch and ulcerate. Typically, these plaques develop on the face or buttocks or within skin folds. As a skin lymphoma rash progresses, papules may start to appear. Some individuals with skin lymphoma also experience erythroderma, a reddening of the skin thats often accompanied by dryness, itchiness and scaliness.
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Symptoms Of Multiple Myeloma
Initial multiple myeloma symptoms may be mild or even undetectable. A precursor stage is known as smoldering multiple myeloma . It may continue to worsen until the cancer is discovered. Though SMM is typically slow-growing, patients may need frequent testing to monitor its progression.
As abnormal plasma cells grow, divide and take over the bone marrow, the likelihood of developing symptoms increases. Not only do abnormal plasma cells crowd out healthy bone marrow cells, damaging the bone, but they also release antibodies, M protein and other proteins into the blood, thickening it.
Many people show symptoms of bone damage, bone loss and bone fracture. Multiple myeloma may also lead to kidney damage and injury and dysregulated blood levels of antibodies and proteins.
Multiple myeloma symptoms vary for each person. Some common signs include:
- Pain in the bones of the back or ribs
- Bones that fracture easily
- Frequent infections and fevers
- Frequent need to urinate and extreme thirst
The bone damage associated with multiple myeloma occurs mostly in the rib cage, spine and pelvis, increasing the risk of spinal cord compression, which causes pain, numbness or weakness in the limbs and requires immediate treatment. It may come on gradually or suddenly.
Multiple myeloma treatment: The care you need is one call away
Your multidisciplinary team will work with you to develop a personalized plan to treat your multiple myeloma in a way that fits your individual needs and goals.