Itchy Skin and Bumps With Lymphoma? It Could Be Prurigo Nodularis | MyLymphomaTeam

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Itchy Skin and Bumps With Lymphoma? It Could Be Prurigo Nodularis

Medically reviewed by Fatima Sharif, MBBS
Written by Joan Grossman
Posted on August 17, 2023

Itchy skin, sometimes accompanied by bumps or rashes, is an uncomfortable symptom that can occur with lymphoma. MyLymphomaTeam members have described their frustrating experiences with itchy bumps. “I have non-Hodgkin’s lymphoma. Now I have these lesions that itch like crazy popping up everywhere,” wrote one member. “They don’t go away and itch a lot. Not any type of bites! Went to the dermatologist and he finally biopsied them. Hopefully I’ll find out something.”

In rare cases, lymphoma rashes may be caused by cutaneous B-cell or cutaneous T-cell lymphoma — two types of lymphoma that affect the skin. An itchy rash may also be a sign of prurigo nodularis (PN), a chronic inflammatory skin condition that can develop in some people who are living with lymphoma.

If you have itchy bumps or skin lesions with lymphoma, it’s important to discuss these symptoms with your doctor to determine if you may have prurigo nodularis or another skin condition.

Read more about causes and symptoms of prurigo nodularis, as well as where to find support if you’re living with this itchy skin condition along with lymphoma.

What Is Prurigo Nodularis?

Prurigo nodularis symptoms can include papules, raised bumps less than 1 centimeter wide. (CC BY-NC-ND 3.0 NZ/DermNet)

Prurigo nodularis is a skin disease that starts with pruritus (intense itching). Rubbing, scratching, and picking itchy skin with PN cause nodules (bumps) to develop in the skin. PN symptoms can develop anywhere on the body that can be scratched or rubbed, but itchy bumps more commonly develop on arms, legs, torso, and buttocks.

Early signs of PN can be short episodes of itching or itching that persists over time. Itching will occur initially without bumps or any rash. Early symptoms may be experienced as stinging, burning, or other sensations other than itching. In some cases, PN may feel like insects are crawling on your skin.

Larger nodules may be easily scratched open and form wounds. (CC BY-NC-ND 3.0 NZ/DermNet)

Itchy bumps tend to appear approximately six weeks after early symptoms begin. These bumps typically develop evenly on both sides of the body. They may or may not be discolored and can range in size from very tiny to approximately 1 inch in diameter. Some people develop just a few nodules while others may have more than 100. People with prurigo nodularis can also develop patches of raised itchy skin, along with bumps that often feel hard and pebbly.

Scratching can aggravate PN and cause it to spread. Scratching and picking can also cause sores to open and bleed. In more serious cases, some people develop spots or scars on their skin that may linger for months or years.

Prurigo nodularis can have a serious impact on quality of life and may affect self-esteem, sleep (which can be a problem with lymphoma itself), and mental health. You can find more information about PN at MyPrurigoTeam and connect with others who are living with PN.

Risk Factors and Causes of Prurigo Nodularis

Researchers do not fully understand the causes of prurigo nodularis, although there’s indication it’s linked to dysfunction in the immune system and abnormalities in nerve fibers in the skin.

Dermatology studies indicate that people with other health conditions that cause itchy skin — such as allergies, atopic dermatitis (the most common type of eczema), and contact dermatitis — have a higher risk of developing prurigo nodularis.

Other conditions that are associated with prurigo nodularis include:

  • Infections such as tuberculosis, herpes zoster, hepatitis C, and HIV
  • Systemic diseases such as kidney disease, thyroid disease, and diabetes
  • Malignancies, including liver, skin, and blood cancers
  • Psychological disorders such as anxiety or depression, along with the use of antidepressants

People between the ages of 51 and 65 are more likely to develop PN. According to NORD, the condition is more common in women than in men, and women tend to experience more severe symptoms. PN “disproportionately affects Black patients and other minority groups,” according to Johns Hopkins.

Links Between Lymphoma and PN

Research has shown links between cancer and prurigo nodularis, although scientists don’t fully understand the exact causes for these links. Studies have found that people with PN have cancer at a rate that is more than four times that of the general population. Researchers have found associations particularly between blood cancers and PN, especially non-Hodgkin’s lymphoma, the most common type of lymphoma.

In some cases, PN may be an early sign of lymphoma or another malignancy or systemic disease. Health experts recommend that people with PN be tested for other diseases associated with the skin condition.

Diagnosis and Treatment of Prurigo Nodularis

PN may not be easy to diagnose. A dermatologist generally starts with a physical examination and a review of family and medical history. However, PN can be difficult to recognize because it mimics other skin disorders. PN can also look different across various cases, which further make it difficult to identify. Sometimes a doctor will perform a skin biopsy — in which the skin is scraped in order to examine skin cells — to help with diagnosis by ruling out other skin diseases.

“I was told of my diagnosis with prurigo nodularis in 2023. I first broke out in 2018 and no doctors in my area had a clue,” a MyPrurigoTeam member wrote. “Suddenly after two years with no new sores, all hell broke loose. My arms are covered, some on my neck, chin, around my waist. Same thing from doctors. Four doctors in a row said they've never seen it. I went to an ER out of my area, and they were great. I’m about to start new meds.”

Managing Prurigo Nodularis

Although diagnosing and treating PN can sometimes be challenging, a variety of treatment options have proven helpful in reducing symptoms, and newer therapies are showing promising results. PN can be managed with a combination of behavior modifications and medications. For people with both lymphoma and PN, treating the lymphoma may clear PN bumps and relieve itchiness.

Therapies used to manage PN include:

  • Topical treatments such as corticosteroids (steroids) and calcineurin inhibitors
  • Ultraviolet phototherapy
  • Immunosuppressive medications such as tacrolimus, methotrexate, thalidomide, or lenalidomide
  • The biologic drug dupilumab (Dupixent)
  • Neuropathy (nerve disorder) treatments such as gabapentin or capsaicin
  • Cryotherapy (extreme cold)

It may take time to find an effective combination of treatments to relieve PN symptoms.

Self Care With PN

People with PN can take steps to protect their skin. It’s essential that people with the condition protect their skin from scratching and keep their fingernails short. Gloves or mittens are advised when people with PN have difficulty controlling their scratching. When bumps are inflamed or especially itchy, they may need to be bandaged. Loose, soft clothing that covers affected skin is also recommended.

Skin care may also include using anti-itch cream with menthol or camphor and sedating antihistamines before bedtime to help with sleeping. People with PN should consistently use moisturizer to keep skin from becoming dry. You should use only gentle, fragrance-free skin care products for sensitive skin if you have PN.

Find Your Team

MyLymphomaTeam is the social network for people with lymphoma and their loved ones. On MyLymphomaTeam, more than 15,000 members come together to ask questions, give advice, and share their stories with others who understand life with lymphoma.

Have you had itchy skin and bumps with lymphoma? Were you diagnosed with prurigo nodularis? Share your experience in the comments below, or connect with other people living with prurigo nodularis on MyPrurigoTeam.

    Posted on August 17, 2023
    All updates must be accompanied by text or a picture.

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    Fatima Sharif, MBBS graduated from Aga Khan University, Pakistan, in 2017 after completing medical school. Learn more about her here
    Joan Grossman is a freelance writer, filmmaker, and consultant based in Brooklyn, NY. Learn more about her here

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