Skin Rash

[Champlain]

I have developed a skin rash all over my body for over a month now. I finished my second round of treatment; rituximab at the end of August 2023 and I have another year to take Venetoclax but my oncologist advised to stop Venetoclax for 3 weeks now. The rash is still going, does anyone have experience this? I have already taken some medications: prednisone,5 days; Fluconazole, 7 days; and some ointment twice a day but does not seem to help. Any advise?

[scryer99]

I had emergent rashes about four months in on a combination therapy regimen, coinciding with me reaching higher dosages and also with my local springtime which results in increased exercise for me. I was getting extremely itchy and irritated skin, which started in armpits and groin but rapidly spread.

I ended up consulting a dermatologist specializing in oncology skin issues. My oncology treatment team was less than forthcoming about this option until I put my foot down and talked to the presiding doctor, who immediately (three hours) got me in to see such a dermatologist.

That specialist diagnosed as Toxic Erythema of Chemotherapy (that does include immunotherapy common to CLL treatment today). I provided more detail on that in this post and associated discussion: healthunlocked.com/cllsuppo...

I was prescribed some heavy-duty antihistamines and topical steroids. They have managed the issue well.

[Champlain in reply to scryer99]

Thanks scryer 99, your advise was helpful. Appreciate

[Skyshark]

How much water are you drinking a day? I had a rash, it was very itchy and burning. Started on lower arms, midriff and upper thighs but was spreading. Raised red bumps, there was a pattern in it like cellulite. I doubled my water consumption to about 2.5L a day and it was gone in 24 hours.

[Champlain in reply to Skyshark]

Thanks for your advise. I appreciate and will try to increase my water intake

[lankisterguy Volunteer]

Hi Champlain,

I have experienced Petechiae and occasionally mildly itchy skin and plaque psoriasis since 2006, but Ibrutinib really made the rash strongly itchy.

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Over the years I've had many biopsies; dermatologists and pathologists postulated Psoriasis, Eczema, drug reactions, and more recently CTCL or Mycosis Fungoides. My CLL expert doctor thinks that my refractory HHV6a infection is the cause.

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The common result from a top expert skin pathologist that ran flow cytometry on the biopsy, was finding many T-cells and CLL cells in a specific layer of my skin. But the puzzle is why they are there.

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Our archives have over 441 postings that mention rash:

healthunlocked.com/cllsuppo...

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And over 1,077 postings that mention skin issues and CLL:

healthunlocked.com/cllsuppo...

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The NIH has several papers suggesting that CLL itself leads to skin issues, as noted here:

ncbi.nlm.nih.gov/pubmed/174...

SNIP: "Cutaneous lesions occur in up to 25% of patients with chronic lymphocytic leukemia (CLL). These can be caused by either cutaneous seeding by leukemic cells (leukemia cutis, LC) and other malignant diseases or nonmalignant disorders. Skin infiltration with B-lymphocyte CLL manifests as solitary, grouped, or generalized papules, plaques, nodules, or large tumors.....The most common secondary cutaneous changes seen in CLL are those of infectious or hemorrhagic origin. Other secondary lesions present as vasculitis, purpura, generalized pruritus, exfoliative erythroderma, and paraneoplastic pemphigus. An exaggerated reaction to an insect bite and insect bite-like reactions have been also observed".

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Here is a 2023 article on how the immune system reacts to skin injury or causes autoimmune reactions:

the-scientist.com/news-opin...

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My most successful treatment was Photo therapy (lightbox treatment with UVB rays 3X per week- similar to a stand up tanning bed, but with medical precision on light frequency and duration).

daavlin.com/patient/uv-phot...

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I obtained a home unit in December 2020, it's 2 meter/ 6 ft high with 8 special fluorescent bulbs see:

daavlin.com/product/patient...

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The psoriasis & seborrheic keratosis is in full remission and I only need 1 treatment per week - a total of 8.5 minutes exposure to keep it under complete control.

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Len

[crystal3333]

Hi Champlain

I am on the same Treatment as you,

But so far I have been lucky and not had any problems, I hope you can find the answers from someone on here.

[Gojarnel]

I also had a skin rash while on venetoclax. I went to see my dermatologist and he diagnosed some kind of psoriasis. He prescribed me calcitriol (Silkis) at first but it didn’t work. Than, he gave me a sample of a new medication called roflumilast (Zoryve) and in a couple of weeks my psoriasis was gone. It is a new medication very costly but the company offers samples for free, ask your dermatologist. I hope this is helpful.