Lymphoma is a cancer originating in lymphocytes, infection-fighting cells of the immune system within the lymphatic system. While many symptoms can arise, itching can be a symptom for some individuals with lymphoma. It is important to understand that itching is a common symptom of many conditions and does not automatically indicate lymphoma.
Where Lymphoma Itching Occurs and Its Characteristics
Itching associated with lymphoma can manifest in various ways, sometimes affecting the entire body, known as generalized pruritus. It can also be localized to specific areas, frequently observed on the lower legs, arms, or back. The itching can also appear near affected lymph nodes, such as in the armpits.
This itching is often described as intense and persistent, sometimes worsening at night or after a hot bath or shower. Its severity can significantly disrupt daily activities and sleep patterns. Unlike typical skin irritations, this itching often occurs without a visible rash or obvious skin lesions.
However, prolonged scratching can lead to secondary skin changes, such as excoriations or thickened skin. In some types of skin lymphoma, a rash may be present, which can feel hot, sore, and intensely itchy, particularly in conditions like Sézary syndrome.
Understanding the Causes of Lymphoma Itch
Itching in lymphoma patients is thought to result from the body’s immune response to the cancer. The immune system releases chemicals that irritate nerve endings in the skin, leading to the sensation of itch.
Cytokines, small proteins regulating immunity and inflammation, are a primary factor. Specific cytokines, such as interleukin-4 (IL-4), interleukin-13 (IL-13), and interleukin-31 (IL-31), have been implicated in stimulating nerve endings and contributing to pruritus.
Other substances, including histamine, serotonin, proteases like tryptase, and neuropeptides such as Substance P, can also play a role in this nerve irritation.
Managing Itching Associated with Lymphoma
Managing lymphoma-related itching involves general care and medical treatments. Practical measures can include regularly moisturizing the skin with fragrance-free products, especially after bathing. Applying cool compresses to itchy areas, wearing loose-fitting clothing, and avoiding hot baths or showers can also help. It is also helpful to keep fingernails short to minimize skin damage from scratching.
Over-the-counter options such as oral antihistamines, particularly sedating ones taken at night, may provide some relief. Topical creams containing menthol or capsaicin can also be applied to distract the nerve endings and mask the itch.
For more persistent or severe itching, a healthcare professional might consider prescription treatments. These can include stronger antihistamines, topical or oral corticosteroids, or medications like gabapentin. Certain antidepressants, such as doxepin or mirtazapine, have also shown anti-itch properties. In some cases, phototherapy, which uses ultraviolet light, can be effective. Treating the underlying lymphoma itself often leads to significant improvement in itching.
Associated Symptoms of Lymphoma
While itching can be a symptom of lymphoma, it often appears alongside other indicators. One common sign is the painless swelling of lymph nodes, frequently found in the neck, armpits, or groin. These enlarged nodes usually feel firm and rubbery.
Other systemic symptoms, often referred to as B symptoms, include unexplained fevers that may come and go, and drenching night sweats. Unexplained weight loss, specifically losing 10% or more of body weight over six months without trying, is another important symptom. Persistent fatigue, which is not relieved by rest, can also be present. Depending on where the lymphoma is located, individuals might experience a cough or shortness of breath if lymph nodes in the chest are affected. These symptoms can be indicative of many conditions, and a medical evaluation is necessary for proper diagnosis.