Medically known as “pruritis”, itchy skin is a problem we are all familiar with. It can become very irritating, especially if the underlying cause is unclear. Possible causes range anywhere from the clothes you wear, to dry skin, to certain skin disorders such as eczema or dermatitis. In very rare cases, itchy skin can be caused by a serious underlying condition such as leukaemia.
According to our patient survey “Living Well with Leukaemia”, around 9% of people with leukaemia will experience itchy skin as a symptom prior to their diagnosis. Read on to gain a better understanding of the causes of itchy skin, so that you can spot leukaemia sooner.
Spotting the difference
It is very difficult to differentiate between itching that is due to leukaemia (or another cancer) and itching that is caused by a benign condition such as a skin allergy. However, there are a few things to look out for that should be treated with concern:
- The itch is all over your body
Dry skin is usually responsible for generalised (‘whole-body’) itching. However, if your skin isn’t dry and the itch is all over your body, this could be a sign of a systemic underlying problem and so is worth getting checked by your GP, certainly if it lasts for longer than 2 weeks or keeps coming back.
If you are pregnant or undergoing menopause, a whole-body itch is nearly always due to hormonal changes and should get better over time.
- Not associated with a visible rash or dry skin
Most of the time, itching can be clearly tied to a rash, indicating an infection, allergic response, or chronic skin condition such as eczema.
If your skin isn’t dry and you can’t find an obvious cause of your persistent itching, make sure you mention it to your GP.
- Itching occurs alongside other symptoms of leukaemia
Leukaemia patients with itchy skin often also report experiencing night sweats as a symptom before their diagnosis; both of these symptoms can become more severe at night.
If you are experiencing any other symptoms of leukaemia such as night sweats, weight loss, easily bruising, repeated infections, fever, or joint and bone pain, contact your GP immediately.
What causes itchy skin in leukaemia?
The exact reason people with leukaemia or lymphoma sometimes develop itchy skin is not conclusively proven and is up for debate in scientific literature. Many researchers believe it is caused cytokines; chemicals released into the blood by the body’s immune system. When immune cells come into contact with leukaemia or lymphoma cells, they can release cytokines at high levels, causing irritation of nerve endings within the skin and thereby a persistent itch.
Topical creams may allow temporary relief, but since the chemicals are released directly into the bloodstream, the itch will always return.
Itchy skin in other blood cancers
As well as leukaemia, two other blood cancers are distinctly notorious for causing itchy skin: lymphoma and polycythaemia vera (PV).
Generally speaking, itching in lymphoma is caused by a specific type called Hodgkin’s lymphoma (HL), with 1 in 3 HL patients experiencing it as a symptom before their diagnosis. It is not usually associated with an obvious rash and typically affects the whole body or can be localised to the lower legs. The itch is severe and is often described as a ‘burning’ sensation.
Some rarer forms of lymphoma such as cutaneous T-cell lymphomas can cause an itchy rash by directly invading the skin tissue. They largely occur as reddish or purple scaly areas of skin and can arise in skin folds – quite often they are mistaken for other conditions such as eczema or psoriasis. The rash may grow in size as the lymphoma progresses and may also occur alongside small lumps that form within the skin.
If you are worried about itching caused by a new rash or a lump in the skin, make sure you visit your GP.
- Polycythaemia Vera (PV)
PV, classified as a myeloproliferative neoplasm, is a slow growing blood cancer that causes too many red blood cells to be produced. Itching is one of the most common symptoms of this disorder, experienced by approximately 40% of patients. It is usually caused by an abnormal production of histamine, the same chemical your body releases during an allergic reaction.
In PV, itching becomes particularly noticeable after a hot bath or shower.
When should I be concerned?
In most cases, itchy skin is nothing to be concerned about. However, if your itchy skin is long-lasting, all over your body and you can’t put your finger on an obvious cause, make sure to make an appointment with your GP.
A full examination by your GP is necessary to accurately determine the cause and rule out any serious underlying issues. Although extremely unlikely, a full blood test will be able to establish whether a systemic underlying problem such as blood cancer, thyroid or kidney disease is a possibility.
It is unlikely that itchy skin will occur on its own as a symptom of leukaemia. Knowing what other symptoms are typical of leukaemia is crucial for helping you to make the decision to visit your GP sooner for a blood test. Connect the dots between the symptoms of leukaemia and spot leukaemia sooner.
For information on the other symptoms of leukaemia, click here.