Multiple Myeloma Skin Conditions: Types and Treatments

Multiple myeloma develops in plasma cells, a type of white blood cell that produces proteins called antibodies that instruct other cells in your immune system to attack foreign invaders.

Myeloma or treatment for myeloma can cause various skin conditions including rashes, sores, and bumps. Symptoms can develop due to:

• the buildup of plasma cells in your skin
• the buildup of abnormal M protein produced by cancer cells
• medication side effects

Less than 1 percent of people with myeloma have a direct involvement of it with their skin.

Plasmacytoma

Plasmacytomas are tumors caused by the abnormal growth of your plasma cells. They can develop anywhere in your body, including your skin. Those are the the most specific sign of skin-related myeloma and usually spreads from your bones.

Less than 100 boxes of the spread of myeloma to people’s skin have been described in the medical literature, but when they do, they are associated with a poor outlook for people with plasmacytoma. A some rare cases plasmacytomas forming at the site of traumatic injury have also been reported.

A plasmacytoma that grows outside your bone and bone marrow is called an extramedullary plasmacytoma. About 7 percent of people with myeloma have an extramedullary plasmacytoma when they are diagnosed, and 6-7% develop one later. They tend to develop if you have aggressive or very advanced myeloma.

Cutaneous plasmacytomas usually appear as red bumps or patches that can form ulcers or sores on the lining of the stomach or small intestine.

Leukocytoclastic vasculitis

Leukocytoclastic vasculitis is an inflammation of your small blood vessels caused by the breakdown of white blood cells called neutrophils. This is rare if you have myeloma.

Symptoms include:

A 2018 case study presented an 85-year-old Japanese woman who developed leukocytoclastic vasculitis as one of the first signs of myeloma.

Autoimmune bullous disease

Autoimmune bullous disease is a group of skin conditions that result from an autoimmune reaction. Although rareit has been reported as the initial sign of myeloma.

For example, in a 2018 case studya 55-year-old man developed vesicular skin lesions on his trunk and scalp that were identified as a type of autoimmune bullous disease called pemphigus vulgaris.

pyoderma gangrenosum

Pyoderma gangrenosum is a rare condition that causes large, painful ulcers, usually on the legs. It can develop as a result of an abnormal immune response if you have cancer. It usually develops in untreated myeloma.

A study found evidence that lenalidomide, a myeloma drug, caused or contributed to the development of pyoderma gangrenosum in a person on treatment.

Bruising and abnormal bleeding

If you have myeloma, you may experience abnormal bleeding or bruising due to a low platelet count. Platelets are blood cells that help your blood clot after an injury.

Bruising or abnormal bleeding can be among the first symptoms of myeloma.

Cryoglobulinemia

Cryoglobulinemia is a rare complication myeloma which can cause severe symptoms such as gangrene or areas of dead tissue called necrotic ulcers. It occurs when myeloma cells produce cryoglobulin, proteins that clump together at temperatures below your normal body temperature.

Cryoglobulinemia can be among the first signs of myeloma.

AL amyloidosis

Amyloid light chain (AL) amyloidosis is a disease in which abnormal proteins called light chains build up in tissues such as the heart, kidneys or skin. These light chains can be produced by your cancerous plasma cells if you have myeloma.

In a 2018 study, researchers found AL amyloidosis in the skin of 32 people with myeloma. They found that about two-thirds of those identified, who were divided into groups labeled male and female, were female and that cutaneous AL amyloidosis was associated with a very poor outlook for people with myeloma.

More than half of the people in the study developed bleeding blisters.

Medication side effects

Some drugs used to treat multiple myeloma, such as Velcade (bortezomib) and Revlimid (lenalidomide), can cause skin side effects such as:

Skin cancer

If you have myeloma, your immune function is impaired, which can increase your risk of second cancer.

A 2016 study found that people with myeloma developed skin cancer at a rate of 26.8%, compared to 16.1% in the control group or the group of people without myeloma.

The following gallery shows images of skin conditions associated with multiple myeloma.

Treatment of the underlying myeloma is essential for the treatment of associated skin conditions. Additional treatments may be used to manage symptoms during treatment.

Here are some examples of treatment options.

Certain skin conditions are associated with a poorer outlook for people with myeloma. Half of the people who develop a cutaneous plasmacytoma live less than 8 months.

A study found that the majority of people with cutaneous AL amyloidosis live less than 6 months.

Here are some frequently asked questions about skin conditions associated with multiple myeloma.

Are skin problems common with multiple myeloma?

Skin problems are not among the most typical signs of multiple myeloma. Cutaneous plasmacytomas are extremely rare but are the most specific cutaneous sign of myeloma.

Does multiple myeloma cause skin discoloration?

Cutaneous plasmacytomas usually present on lighter skin as red bumps or whitish patches that can form ulcers. On darker skinthe bumps may appear darker red or purplish in color, and the plaques may have a grayish tone.

Certain other skin conditions associated with myeloma can cause signs such as ulcers or symptoms such as rashes or redness.

Can multiple myeloma treatment cause itchy skin?

Some drugs used to treat multiple myeloma, such as Velcade (bortezomib) and Revlimid (lenalidomide), can cause itchy skin. A doctor or healthcare professional can help you determine if your medications are contributing to your itching.

Can skin conditions be the first signs of myeloma?

Certain skin conditions such as leukocytoclastic vasculitis can be among the first signs, and frequent bruising or abnormal bleeding can be among the first symptoms of myeloma. It’s a good idea to see a doctor any time you notice changes in your skin that don’t have an obvious cause.

Skin symptoms are not typical of myeloma, but they can occur due to the cancer or its treatment. The most specific sign of myeloma is a tumor made up of plasma cells called a plasmacytoma, although this very rarely occurs in your skin.

A doctor can advise you on how to treat any skin symptoms you develop. Many conditions go away when the underlying myeloma is treated, but medications such as corticosteroids can help manage symptoms.