Platelets normal but red marks appearing on skin - CLL Support

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Platelets normal but red marks appearing on skin

CycleWonder profile image
13 Replies

When I was tested 5 days ago, my platelets had returned to normal (147). I noticed a red mark in my arm about 3/4” long. I thought I must have scratched it or something.

This afternoon I have another red mark in my wrist and 8 more smaller marks on my other arm.

Why is this happening now or is related to something other than platelets?

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CycleWonder profile image
CycleWonder
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13 Replies
AussieNeil profile image
AussieNeilPartnerAdministrator

Without photographs, it's very difficult to offer a suggestion of what the red marks could be. Do they look anything like these that SofiaDeo posted yesterday?

healthunlocked.com/cllsuppo...

A good platelet count is not an absolute guarantee against bleeding. The clotting process is extremely complicated and its effectiveness can be disturbed by a number of factors. One example many of us experience (and I appreciate that this isn't yet applicable to you as you are still in watch and wait), is that BTKi drugs also affect clotting efficiency, because they inhibit BTK in platelets. So you can still get bruising, ecchymosis, petechiae and or purpura with good platelet counts. Also, just because your platelet count was good 5 days ago, unfortunately doesn't mean that it's still good today, though I doubt it could have fallen enough to be responsible for these red marks. Platelets have a half life of around 10 days, so if your bone marrow has stopped making them, platelet counts can drop fairly quickly. Has your specialist suggested why your platelet count was previously low? The onset of Idiopathic thrombocytopenic purpura (ITP) can be sudden after a viral infection, for example. It's an autoimmune condition which CLL can predispose us to developing.

I suspect the red marks are unrelated to your platelets, so please don't become overly concerned about my suggestions above, but they do need to be considered and hopefully discarded as not relevant.

Neil

CycleWonder profile image
CycleWonder in reply toAussieNeil

I looked up on Google but nothing seemed to match these. They’re not raised or itchy. They look under the skin, a dark red color.

Red spots
AussieNeil profile image
AussieNeilPartnerAdministrator in reply toCycleWonder

They look and sound like petechiae to me. If so, they should darken to a grey/black then fade away within a week or so. Do let your specialist know, but I consider petechiae to be a very early warning signal of platelet problems. It's when you get extensive bruising that you really begin to get concerned. :)

Neil

CycleWonder profile image
CycleWonder in reply toAussieNeil

Another photo

Another red mark - long one.
bc77 profile image
bc77

I get those often. On the top of my forearms only. They don't hurt or itch so I ignore them. My oncologist didn't seem worried by them.

CycleWonder profile image
CycleWonder in reply tobc77

Thank you. That is reassuring. I never had them before so it was a bit distressing.

SofiaDeo profile image
SofiaDeo

I agree they look like possible petechiae. A few random, intermittent petechiae may mean nothing. Are these places that might routinely get bumped/rubbed/brush against things? Those spots tend to bruise easily, which would correlate with "less risk of it being something serious" than places that only have the weight of clothing on them, as I understand it. FWIW, when my neighbor had petechiae associated with extremely, dangerously low platelets they were literally covering his entire lower legs. And he also had mouth blood blisters a few days previously, plus deeper bruising on the side of his body he sleeps on. His bruising turned really dark overnight. So I agree with Neil, this might need further inquiry, but I wouldn't necessarily run to Urgent Care unless you get a nosebleed or gum (or other) bleed that won't stop. Do you know the last time you had a PT/PTT? As AussieNeil mentioned, platelet level alone is just one part of the blood clotting process. But if these are commonly rubbed areas, it may be nothing other than "easy bruising". I bruise easily even if I brush a shoulder on a doorjamb, but they don't turn really dark, my gums don't bleed when I brush, and minor cuts don't ooze. So even though my platelets run around 100, my doc isn't concerned. Continue to take pics; if there are more tomorrow, call your doc and see what they recommend. Call them anyway if you, like me, forget to mention things like this during visits.

flyhigher profile image
flyhigher

On Acalabrutinib, I get these blotches too, from time to time, random, no reason, no discomfort, about one inch diameter. They eventually fade from the middle out. At my last regular consultation, my haemotologist asked me to send photos of any blotches suddenly appearing, and I did week before last as it happens. His response was to ask me to get a blood test (I assume no more than precautionary) - which I did on Friday. Don't know the results yet but the two most recent blotches (on hand, and below eye) in question have nearly faded away completely. I also had a monster on my leg which ended up as a widening 'fairy ring' reaching six inches diameter before fading to obscurity. Bit weird!

Personally I'm not worried, being reassured that my haemotologist is keeping an eye on things and will leap into action if needs be.

JLJC profile image
JLJC

I also get petechiae occasionally also. My platelets are good. I was concerned at first when I started getting them but no so much now 🍀💪🏼🌞🧜‍♀️

Hi CyclewonderMy husband has one on his nose right now from picking at a "pimple". He is w/w 2 years and plates were lowering last bloodwork but not to a level of concern per specialist.

He is also on blood thinner & tended to bruise easily prior to CLL diagnoses. He has a habit of sleeping with his arms folded across his chest & gets bilateral bruises occasionally on his upper, inner bicep area from the pressure. Probably "tmi" on my part lol but just "fyi"

Be well~

Cookie

CycleWonder profile image
CycleWonder in reply to

My husband sleeps like that too because of his sleep apnea machine!

in reply toCycleWonder

My husband has a machine too 😉

Miller1960 profile image
Miller1960

HiI get the same marks often , mostly on my arms neck and face. I’m on ibrutinib. They are less now as it’s been three years on the medication. I try to handle it, I get most upset when there on my face. My dr. isn’t worried about it, it’s my only side effect of the ibrutinib. Good luck.

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