Hives are itchy, raised welts on the skin, a common condition. Most often, they result from allergic reactions, infections, or environmental factors. While typically benign and temporary, hives can sometimes indicate an underlying health issue. This article explores the infrequent connection between chronic hives and lymphoma, a type of cancer affecting the immune system.
The Link Between Lymphoma and Hives
Chronic hives, known medically as chronic urticaria, can rarely manifest as a paraneoplastic syndrome linked to lymphoma. This means the hives are a symptom triggered by the cancer’s presence, rather than a direct result of tumor growth on the skin. Studies show chronic urticaria can be linked to an increased risk of malignancy, particularly hematologic cancers like non-Hodgkin lymphoma and leukemia, though this association is uncommon.
The mechanisms behind this connection involve immune system dysregulation. Lymphoma affects lymphocytes, and their abnormal activity can indirectly lead to skin reactions. The cancer might cause the release of inflammatory mediators, such as histamine, from mast cells, resulting in hives. In some cases, the immune response against the cancer may inadvertently target healthy tissues, leading to urticaria.
Other Skin Manifestations
Beyond hives, lymphoma can cause other skin changes, distinct from urticaria. Generalized pruritus, or persistent itching without a visible rash, is a common skin symptom. This itching can be severe and precede other signs of malignancy by months or even years.
Other manifestations include specific lesions like patches, plaques, or nodules. These lesions might be red, scaly, or thickened, sometimes resembling common skin conditions like eczema or psoriasis. Mycosis fungoides, a type of cutaneous T-cell lymphoma, often begins as dry, discolored patches, progressing to raised plaques or tumors. These skin changes represent direct involvement of the skin by cancerous lymphocytes, differing from paraneoplastic hives.
Common Lymphoma Symptoms
Hives, if linked to lymphoma, are rarely the only symptom. Lymphoma often presents with systemic indicators known as “B symptoms.” These include unexplained fevers, particularly those above 101.3°F (38.5°C), and drenching night sweats. Unexplained weight loss, defined as a loss of 10% or more of body weight over six months without dieting, is another key B symptom.
Other signs involve the lymphatic system. Painless swelling of lymph nodes in areas such as the neck, armpits, or groin is a common initial indication. These swollen nodes typically feel firm and do not cause discomfort. Persistent fatigue, even after adequate rest, and recurring infections due to a weakened immune system can also accompany lymphoma.
When to Seek Medical Attention
Consult a healthcare professional for chronic or severe hives. This is particularly important if your hives do not respond to typical over-the-counter treatments or if they recur frequently without an identifiable cause. Medical attention is also warranted if hives are accompanied by systemic symptoms associated with lymphoma. These additional symptoms include persistent unexplained fever, night sweats, or unintentional weight loss. The presence of swollen, painless lymph nodes in the neck, armpit, or groin also necessitates a medical evaluation. Prompt medical assessment ensures an accurate diagnosis and appropriate management, rather than self-diagnosing potentially serious conditions.
Understanding Diagnosis
If lymphoma is suspected, a doctor will initiate diagnostic steps. The process often begins with a thorough physical examination to check for enlarged lymph nodes and assess overall health. Blood tests are commonly performed to evaluate blood cell counts and look for other markers.
Imaging studies, such as CT scans or PET scans, may be used to determine the extent of any enlarged lymph nodes or affected organs. The definitive diagnosis of lymphoma requires a biopsy of affected tissue, most often a lymph node. This tissue sample is then examined under a microscope by a pathologist to identify the specific type of lymphoma.