Skin Problems in Childhood Cancer Survivors

Telangiectasias are commonly called spider veins. They are small vessels on the surface of the skin.

They can appear in the areas where the patient received radiation.

They happen because radiation causes change to the lining of blood vessels.

Spider veins usually do not cause health problems.

Fibrosis is caused by scarring of the lining of the blood vessels. It gives the skin a “woody” texture.

The skin may not be as flexible as healthy skin.

Moisturizing the area can help protect the skin from injury such as cuts and scrapes.

Healing can be slow in these areas because the blood supply is not as good.

Scleroderma may present in patients with chronic graft versus host disease after a hematopoietic cell transplant (sometimes called bone marrow transplant or stem cell transplant.)

Scleroderma occurs when donor white blood cells attack the patient’s skin cells.

The skin becomes stiff. If this happens in the skin around joints, joint mobility can be affected.

Treatment for scleroderma is focused on treating the chronic GVHD.

It is also important to avoid injury to affected skin that can be slow to heal.

Vitiligo may appear after transplant. It is a loss of pigment on patches of skin.

Vitiligo occurs because donor white blood cells attack the patient’s skin cells called melanocytes. These cells control skin color.

Vitiligo happens because of graft versus host disease or other autoimmune disorders. Treating the underlying disease may not cause the color to return to the white patches because damage may be permanent.

It is important to protect skin without pigment because is vulnerable to sun damage.

Hyperpigmentation is a darkening of the skin or nails. It may occur after radiation or some types of chemotherapy. The chemotherapy agents most commonly associated with hyperpigmentation include:

• Bleomycin
• Busulfan
• Cyclophosphamide
• Dactinomycin
• Fluorouracil
• Hydroxyurea
• Methotrexate

Hyperpigmentation usually fades over time without any treatment.