Hodgkin Lymphoma and Rash: What’s the Link?
Medically reviewed by Doru Paul, MD
Lymphoma is a cancer of the lymphatic system, with two major types: Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). Rashes in HL aren’t very common but can occur as a symptom of the disease or as a side effect of some treatments. Rashes are more likely to occur in NHL, which includes over 50 subtypes, some of which involve the skin.
This article will review the symptoms of rash associated with lymphoma and how lymphoma is diagnosed and treated.
Antonio_Diaz / Getty Images
Common Symptoms of Hodgkin Lymphoma
A rash isn’t often a symptom of Hodgkin lymphoma. However, itching without a rash can be a common symptom. In some cases, the itching may be severe.
Common symptoms of HL include:
Enlarged lymph nodes, usually in the neck or armpit
Fatigue
Unintentional weight loss
Fever
Night sweats
Itching
Developing a Rash After an HL Diagnosis
If you have been diagnosed with Hodgkin lymphoma and develop a rash, report it to your healthcare provider. Make a note of when the rash started and what it looks like.
As a rash is not typical for HL, it may have a different cause, such as an infection, medication side effect, allergic reaction, or skin sensitivity to an irritant.
Common Symptoms of Non-Hodgkin Lymphoma
The symptoms of NHL may be similar to HL. However, rash and itching are more common in NHL, especially in the subtypes of lymphoma that directly involve the skin. Symptoms of NHL can vary, but common symptoms include:
Swollen lymph nodes
Unintentional weight loss
Fevers
Drenching night sweats
Abdominal pain
Shortness of breath
Types of skin involvement seen in cutaneous lymphomas can include:
Itchy skin
Small pimple-like lesions, can be red or purple
Flat, scaly lesions, can be red or purple
Plaques, which are thicker lesions and can be raised or lowered
Bumps or raised tumors on skin
Ulcers (open sores)
Since these rash symptoms may be due to many other conditions, it is important that a healthcare provider assesses them.
Why Does Rash or Itching Occur With Lymphoma?
Itching and rash can occur in individuals with lymphoma for various reasons.
In some cases, itching may result from the release of certain chemicals, called cytokines, produced either by the lymphoma cells or the immune cells interacting with the lymphoma cells. Cytokines promote the inflammatory reaction, which can cause itching.
Furthermore, certain types of lymphoma, such as cutaneous lymphomas, directly involve the skin and can cause itching or skin changes as a symptom.
Medications or other therapies used to treat lymphoma may cause a rash as part of their side effects. Some of the treatments that may cause rash include:
Chemotherapy
Targeted therapy
Radiation therapy
Immunotherapy
Steps to Diagnosing Lymphoma
Diagnosing lymphoma, including cases in which a rash is present, involves several steps to determine an official diagnosis.
The first step is often a visit to a healthcare provider for evaluation of symptoms. During this visit, the healthcare provider will assess for any signs or symptoms and the person's medical history. If a rash is present, it will be assessed as part of this examination.
Following the physical examination, additional diagnostic tests may be ordered. One necessary test is a biopsy, in which a small sample of tissue from the affected area is collected and examined in a laboratory for the presence of lymphoma cells.
In addition to a biopsy, other tests may be ordered to help confirm a diagnosis of lymphoma and assess the full extent of the disease. These tests may include:
Blood tests to evaluate for abnormalities in blood cell counts or markers of inflammation
Imaging tests such as computed tomography (CT) scan or positron-emission tomography (PET) scan to visualize the lymph nodes and other organs
Bone marrow biopsy to assess for lymphoma in the bone marrow
Once a diagnosis of lymphoma is determined, additional testing may be performed to determine the specific subtype of lymphoma and its stage, which helps guide treatment decisions.
Treatments to Manage Lymphoma-Related Rashes
Treatment for lymphoma-related rashes depends on the specific type of lymphoma, the stage of the lymphoma, and if the rash is due to the lymphoma, is a side effect of treatment, or stems from another cause.
One treatment may be a topical medication, such as corticosteroid cream or ointment, which can reduce inflammation and itching, from the rash. These medications are applied directly to the affected areas of skin. If rashes are widespread, oral corticosteroids may be needed to treat the rash.
For NHL of the skin, phototherapy (light therapy) may be used as a treatment. This involves exposing the skin to ultraviolet (UV) light, which can help reduce the size of the rash and control symptoms.
Other NHLs of the skin that produce a rash may need systemic therapy, such as chemotherapy or immunotherapy. These treatments are often given intravenously to attack cancer cells throughout the body.
In some cases, radiation therapy may be used to treat skin changes from lymphoma. This involves directing high-energy beams of radiation at the affected areas of the skin to destroy cancer cells.
When to See a Healthcare Provider
When being treated for Hodgkin lymphoma or NHL, it's important to be aware of any changes or new symptoms that develop. During treatment, certain instances may require seeking medical advice. Some of these instances include:
Development of new symptoms
Worsening of a rash, in which it becomes more severe, spreads to new areas, or doesn’t improve with treatment
Persistent symptoms not improving with treatment
Signs of infection, including redness, warmth, swelling, or drainage from the rash
Summary
Although lymphoma is a cancer of the lymph nodes, the disease itself or the side effects of treatments may cause rash or itching to the skin. Treating the symptoms may consist of systemic or topical medications or other therapies such as phototherapy.
It is important for someone with worsening or not improving symptoms to see their healthcare provider for assistance in treating them.
Read the original article on Verywell Health.
