Skin biopsy bleeding

[Suzanne1970]

Hi all,

I started treatment in April (Ibrutinib) and it’s doing what it should do.

I had a skin biopsy on my leg on Tuesday with 4 stitches. The wound is still bleeding today 4 days later!! Just a slow bleed but having to change dressings a few times a day! Does anybody have any experience of similar?

Suzanne

[Walkingtall62]

Hi, I don’t know much, but did you stop your medication before the biopsy and afterwards. If not I understand bleeding can be a problem. I realise it is Sunday tomorrow so not sure who you can ask. Take care

[Suzanne1970 in reply to Walkingtall62]

Hi, the doctor at dermatology said it would not be necessary to stop medication.

[wroxham-gb in reply to Suzanne1970]

Ibrutinib is known to cause some bleeding in wounds. If you live near to a hospital with a & e I would get this checked tomorrow for your peace of mind. It's what I would do.Hope this helps.

Stay safe.

Sue

[Suzanne1970 in reply to wroxham-gb]

Thanks Sue

[AussieNeil Administrator in reply to Suzanne1970]

Please feed back your experience to that dermatology doctor, who it seems, is unaware of the recommendation to have an ibrutinib holiday around surgery to prevent just this from happening. BTK inhibitors such as ibrutinib, reduce clotting effectiveness, which along with the usual low platelet counts - common early in treatment, increases the risk of post surgery bleeds.

Can you get in touch with your CLL specialist for their opinion on what to do now? You are in the awkward situation of having to wait a few days for your platelets to recovery their full function if you now stop ibrutinib. Meanwhile, keep your leg elevated as much as possible. Some reasonably firm bandaging around your leg might help too, to put some pressure on the wound, but note that I'm not medically trained.

Neil

[PaulaS Volunteer in reply to AussieNeil]

I agree with Neil re keeping the leg elevated, and putting a bit of pressure on the wound, with a firm bandage. Try not to change the dressing too often, so as not to disturb a clot that might be forming.

Paula

[JigFettler Volunteer in reply to PaulaS]

Agree Paula. It should not be an issue if no general bruising.

Skin biopsy not deep.

Important to check for local infection as a cause for bleeding. Hence should check a Doc.

Jig

[Suzanne1970 in reply to AussieNeil]

Thanks Neil

[ChattahoocheeBoy in reply to Suzanne1970]

I also regularly need dermatology treatment for skin cancers (sun worship regrets) but have learned CLL patients are even more prone to skin cancers….frequent skin checks are required in my case, so be aware.

[Suzanne1970 in reply to ChattahoocheeBoy]

Thanks

[PaulaS Volunteer]

Hi Suzanne, I'm sorry to hear about this.

I had a small skin biopsy last summer with 2 stitches. I stopped Ibrutinib for a few days before and a few days afterwards. I had some slight oozing (of blood) but it stopped completely after a couple of days.

Doesn't sound good that you're having to change the dressing several times a day, after 4 days. Has dermatology given you a number to ring? Have you got a haematology helpline?

Paula

[Suzanne1970 in reply to PaulaS]

Thanks Paula, I will try my treatment helpline tomorrow

[francc]

I've been on Ibrutinib for 9+ years and I too bleed more than normal. Ask your doctor if there is anything he can recommend. I take curcumin capsules daily. And when I get an occasional nasty cut, I will dab a small bit of it on the wound after a day or two.

[AussieNeil Administrator in reply to francc]

Francc, see if going off curcumin reduces your degree of bleeding. Curcumin has anticoagulant properties: pubmed.ncbi.nlm.nih.gov/225...

Neil

[Suzanne1970 in reply to francc]

Thanks Franc, Great tip!

[francc]

I know that curcumin is known to cause bleeding. I started it (along with high-EGCG green tea from China) in 2002 when Chaya and I talked about it being an anti-inflammatory. Probably a coincidence but my white cell count went from 55k down to 18k within 2 months. Cause vs effect? Maybe, but 'hope' springs eternal. I haven't stopped. I will give it a shot tho. I don't bleed all that much, but the internal bleeding that causes bruising is horrific. My arms make my husband look like a wife beater. Thanks for the suggestion.

[AussieNeil Administrator in reply to francc]

Hi Francc,

There was only in vitro evidence (observation of what curcumin did on CLL cells in blood samples) until human trials a few years ago. Analysing those trial results shows little to no benefit for CLL per: healthunlocked.com/cllsuppo...

The Mayo Clinic trials showed that many of those taking EGCG (pharmaceutical grade Polyphenon-E) experienced a reduction in their absolute lymphocyte counts and node sizes, but because Mitsui Norin withdrew from the oral preparation market, we have no long term data.

Neil

[Cindi73]

I'm having surgery to remove basil cell on my nose. My dermatologist is having me get a letter from my CLL specialist for permission to stop Ibrutnib 4 days before and after the surgery because of bleeding. Wishing you the best. Cindi

[Suzanne1970 in reply to Cindi73]

Hope your surgery goes well x

[Cindi73 in reply to Suzanne1970]

Thank you.

[Suzanne1970]

Thanks so much for all your advice. Thankfully it stopped bleeding early this morning and still dry 12 hours later. Fingers crossed it stays that way 🤞

[PaulaS Volunteer in reply to Suzanne1970]

Hi Suzanne, So glad to hear that the bleeding has stopped now..

[Suzanne1970 in reply to PaulaS]

Thanks Paula, so relieved 😅 x

[Cllsller]

Last month I had biopsy on arm, and I too, am on Imbruvica. It did bleed more than I had expected. I had to change bandage several time a day. It finally stopped about a week later. I am now waiting to have mohs surgery. Best of luck.

[Suzanne1970 in reply to Cllsller]

Thanks, thankfully stopped now but very scary! Hope your upcoming surgery goes well

[Cllsller]

Forgot to mention hat my doctor had me stop Imbruvica for 3 days before and after the biopsy.