People with multiple myeloma can sometimes have skin symptoms, such as lumps, bruises, or raised patches. Learn what these changes may mean, how doctors diagnose them, and when to contact your healthcare team.
What is myeloma rash? How a blood cancer affects the skin
Multiple myeloma is a blood cancer that affects plasma cells. These white blood cells are found in the bone marrow. They normally make antibodies that help protect your body from infections.
Myeloma mainly affects the bones. Yet, some people also develop skin symptoms. These changes may come from myeloma, treatments, infections, or other health conditions.
Myeloma cells rarely grow directly in the skin. This happens in about 1% to 4% of people with myeloma. One example is a cutaneous plasmacytoma, a growth of abnormal plasma cells in or under the skin.
Myeloma may also cause rashes and itching. These symptoms can have many causes. If itching or a rash is your main concern, read Itchy Skin and Myeloma.
What causes skin symptoms when you have myeloma?
Several factors can cause skin changes in people with myeloma:
Myeloma treatments: Some therapies can cause dry skin, irritation, or rashes.
Weakened immune system: Myeloma and certain treatments can raise your risk of skin infections. For example, if a medication is administered through a catheter, the skin around it needs to be examined to prevent skin infections.
Low platelet counts: Platelets help your blood clot. Low platelet levels can cause bruises or tiny red or purple spots called petechiae.
Abnormal protein buildup: Proteins made by plasma cells can collect in the skin and other tissues.
Myeloma cells outside the bone marrow: In rare cases, these cells form growths in the skin.
Your care team can help find the cause. They may check your skin, review your medicines, or order tests.
Multiple myeloma skin lesions: What to look for
A skin lesion is an area that looks or feels different from nearby skin.
Tell your healthcare team if you notice:
New red, purple, or skin-colored bumps
Raised or thick patches of skin
Firm lumps that grow over time
Bruises without a clear cause
Tiny red or purple spots that do not fade when pressed
Sores that do not heal
New freckles or moles
These changes can appear anywhere on your body. Some may hurt, while others cause no pain.
A new skin lesion does not always mean your myeloma is getting worse. Many skin changes have other causes. Doctors cannot tell if myeloma is involved by appearance alone.
Take a photo of any new skin change. Note when it appeared and whether it has changed. This can help your care team assess it.
Cutaneous plasmacytomas: Lumps under the skin
A cutaneous plasmacytoma is a rare growth of abnormal plasma cells. It forms in or under the skin. These growths are a type of extramedullary myeloma. This means myeloma cells are growing outside the bone marrow.
Cutaneous plasmacytomas often look like firm, painless red or purple lumps. They may also form thick, raised patches called plaques. They often appear on the chest, back, or belly. They can also develop elsewhere.
These growths are more common in advanced or relapsed myeloma. Relapsed myeloma means the cancer has returned after treatment. However, skin growths can sometimes appear earlier.
How are cutaneous plasmacytomas diagnosed and treated?
Dermatologists (doctors who specialize in skin, hair, and nail conditions) usually use a skin biopsy to confirm the diagnosis. A biopsy removes a small tissue sample. A specialist then checks it under a microscope.
Your myeloma specialist may order more tests. These tests help check for myeloma in other parts of your body.
Treatment depends on your health and how much myeloma is present. Options may include:
Systemic therapy: Treatment that works throughout your body.
Radiation therapy: Treatment that uses high-energy rays to target a specific growth.
Cutaneous plasmacytomas can be linked to more active myeloma. A clear diagnosis helps your care team decide if your treatment needs to change.
Myeloma-related amyloidosis and the skin
Some people with myeloma develop light chain (AL) amyloidosis.
AL amyloidosis occurs when abnormal proteins called light chains build up in tissues and organs. These deposits can affect how the body works.
When these proteins collect in the skin or blood vessels, they may cause:
Easy bruising, often around the eyes
Red or purple spots
Waxy or thick skin
Small raised bumps
Changes in skin texture
Bruising around the eyes can be a sign of AL amyloidosis. Other health conditions can also cause this symptom.
Amyloidosis can affect the heart, kidneys, nerves, and digestive system. It may occur with myeloma or on its own.
If your care team suspects amyloidosis, they may order blood or urine tests. They may also take a tissue sample.
Finding amyloidosis helps doctors choose the right care. Treatment aims to lower abnormal protein production and protect affected organs.
Is multiple myeloma skin cancer? Myeloma vs. melanoma
Multiple myeloma and melanoma are two different types of cancer. Their names sound alike, but they affect different cells.
Myeloma starts in plasma cells, usually in the bone marrow. Melanoma is a skin cancer that starts in melanocytes. These cells give your skin its color.
Having myeloma does not mean you have melanoma. Still, research suggests that people with myeloma may have a higher risk of certain skin cancers. These include squamous cell carcinoma and basal cell carcinoma, two types of nonmelanoma skin cancer.
Studies on melanoma risk have found mixed results. Large population studies found no increased risk in people with myeloma. A more recent study found a possible link to a higher risk. Learn more in Higher Rates of Melanoma in Patients with Multiple Myeloma.
Several factors may raise skin cancer risk. These include age, sun exposure, a weakened immune system, and certain treatments. Regular skin checks and sun protection can help you care for your skin.
Protecting your skin when you have multiple myeloma
Daily skin care can help prevent dryness and sun damage. It can also help you notice new skin changes. Here are ways to protect your skin:
Use sunscreen. Choose a broad-spectrum sunscreen with a sun protection factor (SPF) of 30 or higher. Broad-spectrum means it protects against two main types of harmful ultraviolet rays. Reapply every two hours outdoors and after swimming or sweating.
Wear protective clothing. Use long sleeves, wide-brimmed hats, and sunglasses when outdoors.
Moisturize often. Choose gentle, fragrance-free products to help prevent dry skin.
Avoid harsh products. Use mild cleansers and warm water instead of hot water.
Check your skin. Look for new lumps, changing moles, unusual bruises, or sores that do not heal.
Ask about skin exams. Your care team can help you decide how often to see a dermatologist.
Tell your healthcare team about new or changing skin symptoms. This is especially important during treatment.
Seek medical care promptly for skin changes that spread quickly, blisters, peeling skin, or skin changes with a fever.
Trouble breathing or swelling of your face or throat requires emergency care.
What to remember about myeloma and skin changes
Skin changes can have many causes. These include myeloma treatments, infections, and abnormal protein buildup. Myeloma cells growing directly in the skin are rare.
Tell your care team about new lumps, unusual bruises, or other skin changes. Finding the cause can help your team choose the right care.
Unify your complete health story
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Sources:
Increased Risk of Cutaneous Diseases in Multiple Myeloma Patients
Cutaneous plasmacytoma: a rare manifestation of multiple myeloma
Cutaneous manifestations of multiple myeloma and other plasma cell proliferative disorders
Skin-Associated Secondary Plasmacytomas in Multiple Myeloma: A Rare Entity With Prognostic Relevance
Myeloma-associated Systemic Amyloidosis with an Extensive Cutaneous Involvement
Risk of skin cancer in multiple myeloma patients: a retrospective cohort study
Risk of skin cancer in multiple myeloma patients: a retrospective cohort study
