Leukemiais a type of cancer that interferes with normal blood clotting and places other stresses on the body, including the skin.
A leukemia rash can occur in the early stages when tiny blood vessels burst and cause little red, brown, or purple dots. A rash can also develop with advanced leukemia or as a result of leukemia treatment. Other skin-related symptoms can include nodules, blisters, easy bruising, pale skin, and skin infections.
This article discusses the causes and symptoms of leukemia rashes and other skin changes. It also covers how each is managed or treated.
Verywell / Ellen Lindner
What Skin Symptoms Occur From Leukemia?
In early-stage leukemia, rashes happen because the disease interferes with the production ofplatelets(thrombocytes), a type of blood cell responsible for blood clotting. In someone with leukemia, these cells are misshapen and nonfunctional.
Leukemia also damages the walls of blood vessels, making them vulnerable to rupture. Without enough healthy platelets to form clots, blood can flow freely into the surrounding skin when weakened capillaries burst, producing spots under the skin.
Leukemia rashes can appear just about anywhere on the body. Some common locations are the chest, trunk, legs, feet, neck, face, hands, and arms.
These are some of the skin conditions that can occur with leukemia. Some are early signs of the disease, while others may appear in later stages or as a side effect of medication.
A Word From VerywellIf you have a ‘spot’ on your skin that has bothered you—an unexplained bump, bruise, or pinpoint pain—these are not necessarily causes for alarm, but they are a cause for further study. Unexplained bruises or sores in your mouth can be a sign of leukemia. In addition, a collection of a specific white blood cell (mast cells) on the skin can result in an elevated area that stings to the touch, which can indicate leukemia. If you have concerns, bring them up with your healthcare provider.—STEFFINI STALOS, DO, MEDICAL EXPERT BOARD
A Word From Verywell
If you have a ‘spot’ on your skin that has bothered you—an unexplained bump, bruise, or pinpoint pain—these are not necessarily causes for alarm, but they are a cause for further study. Unexplained bruises or sores in your mouth can be a sign of leukemia. In addition, a collection of a specific white blood cell (mast cells) on the skin can result in an elevated area that stings to the touch, which can indicate leukemia. If you have concerns, bring them up with your healthcare provider.—STEFFINI STALOS, DO, MEDICAL EXPERT BOARD
If you have a ‘spot’ on your skin that has bothered you—an unexplained bump, bruise, or pinpoint pain—these are not necessarily causes for alarm, but they are a cause for further study. Unexplained bruises or sores in your mouth can be a sign of leukemia. In addition, a collection of a specific white blood cell (mast cells) on the skin can result in an elevated area that stings to the touch, which can indicate leukemia. If you have concerns, bring them up with your healthcare provider.
—STEFFINI STALOS, DO, MEDICAL EXPERT BOARD
Petechiae and Purpura
Wiki Commons.
Petechiaeaffects around 40% of people with leukemia and can sometimes be the very first sign of the disease.Petechiae are pinpoint spots that are painless and may be red, purple, or brownish, depending on your skin tone. They can resembleatopic dermatitis, a common skin rash.
Petechiae differs from similar skin conditions in that the spots do not blanch (whiten) when you press them. The spots typically lie flat against the skin and are no larger than 2 millimeters in size.
When the spot is between 2 millimeters and 1 centimeter, it is referred to aspurpura. These lesions are typically raised but are also usually painless (although some can feel tender). Unlike petechiae, purpura rashes tend to be irregularly shaped.
Easy Bruising
Jay_Zynism/iStock/Getty Images
Ecchymosis, also known as “leukemia bruises,” can appear for no apparent reason. It’s often seen on unusual parts of the body (such as the back, chest, or face).
Some signs that bruising may be a symptom of early leukemia include:
Once you begin to undergo treatment for leukemia, bruising, petechiae, and purpura will usually resolve. Other treatments can target the symptom directly, includingcorticosteroids(steroids) which reduce the swelling of blood vessels, andvitamin C supplements, which help strengthen blood vessels.
Leukemia Cutis
This photo contains content that some people may find graphic or disturbing.See PhotoReproduced with permission from © DermNetdermnetnz.org2023.
This photo contains content that some people may find graphic or disturbing.See Photo
This photo contains content that some people may find graphic or disturbing.
Reproduced with permission from © DermNetdermnetnz.org2023.
Leukemia cutis causes rash-like lesions on the arms, legs, and torso. The lesions can have various possible appearances, such as:
Leukemia cutis results when abnormal white blood cells (calledneoplastic leukocytes) make their way into the skin, causing lesions of various sizes and appearances.
Easy Bleeding
A person with leukemia may bleed more than usual.This is because blood doesn’t clot as effectively in someone with low platelets. You may notice this while doing things that wouldn’t normally cause bleeding, such as:
If you have periods, they may be heavier than usual.
Sweet’s Syndrome
This photo contains content that some people may find graphic or disturbing.See PhotoReproduced with permission from © DermNet New Zealandwww.dermnetnz.org2023.
Reproduced with permission from © DermNet New Zealandwww.dermnetnz.org2023.
Skin changes with Sweet’s syndrome are most likely to be seen on the arms, legs, trunk, face, or neck.
Sweet’s syndrome can affect people with leukemia as well as those without. When leukemia is involved, it may occur on its own or as a reaction to granulocyte-colony stimulating factor (G-CSF) drugs likeNeulasta (pegfilgrastim)that stimulate the production of white blood cells in people undergoing chemotherapy.
Sweet’s syndrome is treated with corticosteroid drugs that help ease inflammation.
Mastocytosis
This photo contains content that some people may find graphic or disturbing.See PhotoRicciPhotos / Getty Images
RicciPhotos / Getty Images
Mastocytosis happens when white blood cells called mast cells overaccumulate in tissues. It is associated with a type of leukemia called mast cell leukemia, but may also occur in people with AML.
A person with mastocytosis may develop a rash called urticaria pigmentosa, which causes brownish, raised patches of skin that sting or itch when touched. The rash may also hurt or itch in response to changes in temperature.
Other symptoms of mastocytosis can include:
There are few treatments available for mastocytosis. Depending on the severity, your healthcare provider may recommend medications such as:
For people with severe cases, targeted therapies, chemotherapy, and immunotherapy may also be options.
Mouth Sores and Swollen Gums
This photo contains content that some people may find graphic or disturbing.See PhotoReproduced with permission from © DermNetdermnetnz.org2023
Reproduced with permission from © DermNetdermnetnz.org2023
People with leukemia often have chronic mouth sores and infections of the mouth. These can be early signs of the disease. Some of these symptoms include:
These symptoms can be managed with over-the-counter medications or medicated mouthwash. Your healthcare provider may also prescribe steroid medication.
Chloroma
Chloroma, also known as granulocytic sarcoma, is a rare type of cancer that occurs when leukemia cells form a tumorous mass. It can develop on the skin but also in the brain, bones, breasts, intestines, or lungs.
On the skin, chloromas appear as one or several shiny nodules that are firm to the touch and reddish to purplish in color. When cut open, the nodules sometimes have a blue-green interior.The size of the nodules can vary but those on the skin can get as large as a grape.
Chloromas affect up to 9% of people with AML. They commonly occur followingremissionorrecurrenceof leukemia, but can occasionally occur as an early symptom or later complication of the disease.
Chloromas can be managed with chemotherapy to treat the underlying leukemia.
Leukemia-Related Skin Symptoms
Besides causing a rash, leukemia may affect the skin in other ways. For example, in the early stages, you may notice that minor skin injuries bleed much more than usual.This is because blood doesn’t clot as effectively in someone with low platelets. Other skin problems that may occur with leukemia include:
Summary
Skin rashes are common during every stage of leukemia and may even occur in response to certain drugs used to treat leukemia. These include petechiae, purpura, and ecchymosis, which often occurs during the early stages of the disease.
Leukemia cutis, mastocytosis, and chloroma may occur in later stages of the disease or with certain forms of leukemia. Sweet’s syndrome is a rare skin condition that can develop on its own or as a reaction to drugs like Neulasta (pegfilgrastim).
Other skin-related symptoms include easy bruising, pale skin, and bleeding more than usual.
Leukemia treatment can help resolve or improve skin symptoms, including rashes. Other treatments may help treat the rashes themselves, including corticosteroids and phototherapy.
7 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Grunwald MR, McDonnell MH, Induru R, Gerber JM.Cutaneous manifestations in leukemia patients.Semin Oncol.2016;43(3):359-65. doi:10.1053/j.seminoncol.2016.02.020American Cancer Society.Signs and symptoms of acute myeloid leukemia (AML).Kazmi SM, Pemmaraju N, Patel KP, et al.Characteristics of Sweet’s syndrome in patients with acute myeloid leukemia.Clin Lymphoma Myeloma Leuk. 2015;15(6):358-363. doi:10.1016/j.clml.2014.12.009Khan S, Abid Z, Siddiqui HF, Zahoor S, Haider G.Acute myeloid leukemia with occult systemic mastocytosis or atypical mast cells post-induction.Cureus. 2018;10(12):e3734. doi:10.7759/cureus.3734National Library of Medicine.Systemic mastocytosis.Leukemia & Lymphoma Society.Mastocytosis.Singh A, Kumar P, Chandrashekhara SH, Kumar A.Unravelling chloroma: Review of imaging findings.Br J Radiol. 2017;90(1075):20160710. doi:10.1259/bjr.20160710
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Grunwald MR, McDonnell MH, Induru R, Gerber JM.Cutaneous manifestations in leukemia patients.Semin Oncol.2016;43(3):359-65. doi:10.1053/j.seminoncol.2016.02.020American Cancer Society.Signs and symptoms of acute myeloid leukemia (AML).Kazmi SM, Pemmaraju N, Patel KP, et al.Characteristics of Sweet’s syndrome in patients with acute myeloid leukemia.Clin Lymphoma Myeloma Leuk. 2015;15(6):358-363. doi:10.1016/j.clml.2014.12.009Khan S, Abid Z, Siddiqui HF, Zahoor S, Haider G.Acute myeloid leukemia with occult systemic mastocytosis or atypical mast cells post-induction.Cureus. 2018;10(12):e3734. doi:10.7759/cureus.3734National Library of Medicine.Systemic mastocytosis.Leukemia & Lymphoma Society.Mastocytosis.Singh A, Kumar P, Chandrashekhara SH, Kumar A.Unravelling chloroma: Review of imaging findings.Br J Radiol. 2017;90(1075):20160710. doi:10.1259/bjr.20160710
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Grunwald MR, McDonnell MH, Induru R, Gerber JM.Cutaneous manifestations in leukemia patients.Semin Oncol.2016;43(3):359-65. doi:10.1053/j.seminoncol.2016.02.020American Cancer Society.Signs and symptoms of acute myeloid leukemia (AML).Kazmi SM, Pemmaraju N, Patel KP, et al.Characteristics of Sweet’s syndrome in patients with acute myeloid leukemia.Clin Lymphoma Myeloma Leuk. 2015;15(6):358-363. doi:10.1016/j.clml.2014.12.009Khan S, Abid Z, Siddiqui HF, Zahoor S, Haider G.Acute myeloid leukemia with occult systemic mastocytosis or atypical mast cells post-induction.Cureus. 2018;10(12):e3734. doi:10.7759/cureus.3734National Library of Medicine.Systemic mastocytosis.Leukemia & Lymphoma Society.Mastocytosis.Singh A, Kumar P, Chandrashekhara SH, Kumar A.Unravelling chloroma: Review of imaging findings.Br J Radiol. 2017;90(1075):20160710. doi:10.1259/bjr.20160710
Grunwald MR, McDonnell MH, Induru R, Gerber JM.Cutaneous manifestations in leukemia patients.Semin Oncol.2016;43(3):359-65. doi:10.1053/j.seminoncol.2016.02.020
American Cancer Society.Signs and symptoms of acute myeloid leukemia (AML).
Kazmi SM, Pemmaraju N, Patel KP, et al.Characteristics of Sweet’s syndrome in patients with acute myeloid leukemia.Clin Lymphoma Myeloma Leuk. 2015;15(6):358-363. doi:10.1016/j.clml.2014.12.009
Khan S, Abid Z, Siddiqui HF, Zahoor S, Haider G.Acute myeloid leukemia with occult systemic mastocytosis or atypical mast cells post-induction.Cureus. 2018;10(12):e3734. doi:10.7759/cureus.3734
National Library of Medicine.Systemic mastocytosis.
Leukemia & Lymphoma Society.Mastocytosis.
Singh A, Kumar P, Chandrashekhara SH, Kumar A.Unravelling chloroma: Review of imaging findings.Br J Radiol. 2017;90(1075):20160710. doi:10.1259/bjr.20160710
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