See oncologist about itchy skin
Q. I am writing on behalf of my husband. He is 80 years old and suffers from chronic lymphocytic leukemia. Up until the last couple of years, it has progressed very slowly and he was advised to do nothing. Now, however, it has advanced. His white blood count has risen dramatically, his platelet count is very high and his red blood count is low. He also has a problem that no one has been able to solve - his skin is so dry, it continually flakes off and is very itchy. when rubbed. It is also very itchy, but if he scratches, it either bleeds or raises welts. This happens day and night. He has seen a dermatologist who said it might be an allergy to his blood pressure medicine, so it was switched. There was no change, so the dermatologist gave him a prescription for a cream. He has tried every lotion and cream on the pharmacy shelves, but nothing relieved the itch. He even tried castor oil to no avail. Have you ever heard of such intense itching associated with leukemia? Is there any relief to be had? He is about to lose his mind. He is also constantly cold because of his low red blood count but doesn't wear wool, preferring layers, sport silk underwear and fleece jackets. At night he uses an electric blanket.
A. Your husband has a type of cancer that affects the blood and bone marrow. Chronic lymphocytic leukemia (CLL) is a slow, progressive form that affects lymphocytes, a specific type of white blood cell. Chronic lymphocytic leukemia is caused by damage to the DNA of newly forming cells in the bone marrow. Leukemia can develop for two reasons - damage that turns on oncogenes, which control cell division, and damage that turns off tumor suppressor genes that tell cells when to die. In either case, the affected cells cease to function properly. In your husband's case, the lymphocytes gather in the blood and other organs and interfere with the normal blood cell production. The reason why is unknown, but doctors and researchers have found that many people with CLL have types of chromosomal abnormalities. Most cases of CLL aren't inherited, but a small percentage of sufferers have a family history of the disorder or of lymphoma.
Often, there are no early symptoms. But in some cases, fever, weight loss, night sweats, fatigue, lethargy and/or loss of appetite may be present. The disorder is often an incidental finding during normal blood testing. Symptoms of advanced CLL stages can include anemia, which can lead to paleness, fatigue, shortness of breath and more; low white blood cell count, which may cause frequent infections and low platelet numbers, which can lead to bruising, abnormal blood clotting, etc. CLL may also cause bone or joint pain, liver and spleen swelling and enlargement of lymph glands in the stomach, groin, neck or underarm. There are procedures and new medications available for treatment of aggressive or advanced CLL, however, there is no known cure.
I urge your husband to return to his oncologist for further testing and to discuss the possibility of treatment - that is his best chance of finding a solution. While no one seems to know the cause of your husband's skin issue, perhaps it will subside if the CLL is treated. The persistent itching may also be a sign of kidney damage. Perhaps your husband's condition now has progressed to a point where it may be causing organ damage. If your husband recently has undergone radiation treatment, that's another possibility.
If the doctor cannot help, it may be time to turn to super-specialists at a teaching hospital or clinic, such as the Mayo Clinic. Let me know what happens.
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