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Petechiae, or what many people know as “leukemia spots,” are reddish, pinpoint-sized dots that can develop underneath the skin of someone who has leukemia—a cancer that occurs in blood-forming structures such as the bone marrow and lymphatic system. The appearance of petechiae can vary slightly from person to person, but usually involves tiny spots that:

  • Occur in clusters
  • Can be red, purple or brown
  • May appear as a flat, unraised skin rash
  • Do not change color when pressed against

Petechiae tend to be red and quite noticeable in people with lighter skin tones. In people with darker skin, they can look brown and be less apparent. Petechiae most often occur on the arms, hands, legs and feet where blood typically collects, but can also appear on the eyelids, inside the mouth and in other unexpected areas.

Causes of leukemia spots

Small blood vessels known as capillaries connect veins to arteries at their thinnest points. Petechiae can occur when capillaries break open and bleed underneath the skin. Normally, healthy blood platelets help the blood clot and seal off broken vessels, but leukemia reduces the amount of these platelets in the bloodstream and prevents proper clotting.

Petechiae are common and can result from a number of factors other than leukemia, some of which are not serious. For example, petechiae on the face or chest may occur after a prolonged period of vomiting related to a stomach virus, motion sickness or a few too many alcoholic beverages. Certain medications may also cause petechiae, as can infections and disorders such as:

  • Strep throat
  • Mononucleosis
  • Cytomegalovirus (CMV) infection  
  • Endocarditis
  • Vasculitis
  • Thrombocytopenia

People who develop petechiae should promptly consult with a physician to confirm its cause and receive treatment, especially if it is widespread, has no obvious cause or is accompanied by other possible symptoms of leukemia.

Other signs of leukemia

The reduction of healthy white blood cells and platelets caused by leukemia can lead to other skin changes besides petechiae. These changes may include:

  • Multiple unexplained bruises. People with leukemia often bruise very easily, more frequently and in unusual places, such as the back and hands.
  • Leukemia cutis. A rare side effect that occurs when leukemia cells enter the skin, leukemia cutis appears as discolored patches or bumps that may be raised or tender.  
  • Acute myeloid leukemia (AML) rash. Similar in appearance to leukemia cutis, AML rashes occur when acute myeloid leukemia cells reach the skin.

Other common symptoms of leukemia include:

  • Swollen, tender gums  
  • Mouth sores
  • Enlarged, tender lymph nodes
  • Intense fatigue
  • Fever and chills
  • Frequent infections
  • Easy bleeding
  • Unexplained weight loss  
  • Heavy sweating, especially at night  
  • A feeling of pain in the bones or limbs

Moffitt’s approach to leukemia

As Florida’s top cancer hospital, Moffitt Cancer Center stands at the forefront of leukemia treatment and research. Our Malignant Hematology Program features a multispecialty team that focuses exclusively on blood cancers and excels in the most effective leukemia therapies, such as chemotherapy, immunotherapy and bone marrow transplantation. Moffitt also spearheads a trailblazing clinical trial program and ambitious research initiatives, both of which have contributed to our status as a National Cancer Institute-designated Comprehensive Cancer Center.

If you would like to make an appointment to discuss unusual skin changes or receive a second opinion from a leukemia specialist at Moffitt, call 1-888-663-3488 or complete a new patient registration form online. We’re changing the model and prioritizing timely patient care, which means you’ll be connected with a cancer expert in 24 hours or less.