Cancer itself does not directly cause cellulitis, but the disease and its treatments can significantly increase an individual’s susceptibility to this bacterial skin infection. Understanding this relationship is important for cancer patients and their caregivers to help manage potential risks.
Understanding Cellulitis
Cellulitis is a common bacterial infection that affects the deeper layers of the skin and the tissue beneath it. The affected area appears red, swollen, warm, and painful. While it can occur anywhere on the body, it is frequently observed on the lower legs, hands, and face. This infection develops when bacteria, most commonly Streptococcus or Staphylococcus species, enter the body through a break in the skin. Entry points include small cuts, scrapes, insect bites, or cracked and dry skin.
Connections Between Cancer, Its Treatment, and Cellulitis
Cancer and its associated treatments can compromise the body’s defenses, creating an environment where cellulitis is more likely to develop. Surgical procedures, radiation, and chemotherapy each present distinct pathways for increased risk.
One significant factor is lymphedema, a condition often resulting from cancer treatments like surgery or radiation that damage the lymphatic system. The lymphatic system, part of the immune system, drains fluid and fights infections. When lymph nodes are removed or damaged, fluid can accumulate, leading to swelling and stretching of the skin, which makes it more susceptible to cracking and bacterial entry. This impaired lymphatic flow also weakens the local immune response, increasing the risk of infection.
Cancer itself and treatments such as chemotherapy can suppress the immune system. Chemotherapy targets rapidly dividing cells, including immune cells, which reduces the body’s ability to fight off bacteria. A weakened immune system makes individuals more vulnerable to infections, including cellulitis.
Skin integrity issues also play a role in increasing susceptibility. Surgical incisions, for example, create direct entry points for bacteria. Radiation therapy can cause the skin to become fragile, dry, thin, or even lead to burns, providing additional opportunities for bacteria to enter. Tumor growth or ulceration can also compromise the skin barrier, creating open wounds that are prone to infection.
Some chemotherapy agents can induce peripheral neuropathy, nerve damage affecting the hands and feet. This nerve damage can reduce sensation, making it difficult for patients to notice small cuts, scrapes, or other skin injuries. Unnoticed breaks in the skin can then serve as entry points for bacteria, leading to cellulitis.
Identifying and Addressing Cellulitis
Recognizing the signs of cellulitis and seeking prompt medical attention is important, particularly for individuals with cancer. Common symptoms include redness, swelling, warmth, and tenderness or pain in the affected area. The skin may also appear taut, glossy, or dimpled, sometimes resembling an orange peel. Other systemic signs, such as fever, chills, and fatigue, can also accompany the infection.
If these symptoms appear, especially in a cancer patient, immediate medical evaluation is advised. Diagnosis involves a physical examination and a review of the patient’s medical history. Blood tests may check for bacteria or an elevated white blood cell count. A skin sample or swab might identify the specific bacteria causing the infection.
Cellulitis is treated with antibiotics, administered orally or, in severe cases, intravenously. It is important to complete the full course of antibiotics as prescribed, even if symptoms begin to improve, to ensure the infection is fully eradicated. If left untreated, cellulitis can lead to serious complications, including the spread of infection to the bloodstream (bacteremia or sepsis), bones (osteomyelitis), or heart (endocarditis), which can be life-threatening.
Reducing Cellulitis Risk in Cancer Patients
Minimizing the risk of cellulitis for cancer patients involves consistent and careful attention to skin health and managing underlying conditions. Good skin care is a preventative measure. Patients should practice gentle cleansing with mild, fragrance-free, hypoallergenic products and moisturize daily, especially after bathing, to prevent dryness and cracking. Protecting skin from cuts, scrapes, and insect bites is also important, achievable by wearing appropriate clothing, footwear, and gloves during activities like gardening.
For patients with lymphedema, managing the condition is important. This includes wearing compression garments as advised and engaging in physical therapy to control swelling, as reduced swelling can decrease the likelihood of cellulitis. Controlling lymphedema helps maintain tissue health, which is important for preventing infection.
Patients experiencing peripheral neuropathy, particularly in the feet, should regularly inspect their feet for any unnoticed injuries or breaks in the skin. Prompt treatment of any new skin issues, such as rashes, cuts, or abrasions, is also important. Cleaning wounds with mild soap and water, applying antiseptic, and covering them with a clean bandage can help prevent bacteria from entering and causing infection.