Dry and irritated skin
The commonest problem with the skin in the period after bone marrow transplant is a general sensitivity and dryness. Being in hospital tends to dry out the skin and drugs and x ray treatment tend to irritate it.
The risk of irritation can be reduced by using lots of moisturizing agents which also soothe the skin once it has become irritated. The choice of moisturizing agent is largely personal but usually lotions and light creams are both less likely to help and more likely themselves to irritate. Therefore greasier things tend to work better. The main message is that the moisturizers need to be applied generously and frequently. The more the better is usually the rule.
Dry scratched skin becomes “broken” and infection may result because bacteria can enter the cracks, so keeping the skin well moisturized is important because after a transplant patients are at increased risk of infection.
Eczema (or dermatitis) is a condition where the top layer of the skin (the epidermis) is inflamed. The skin becomes red and scaly and noticeably itchy.
It may occur when dryness is allowed to become severe after a transplant, especially in people who are susceptible (or prone) to it. Other people who have asthma or hay fever may also be at risk of eczema and others may develop eczema for the first time.
Eczema is also treated with moisturizers but steroid ointments may also be needed.
The importance of eczema after a transplant is:-
• It is uncomfortable and therefore should be treated promptly
• Cracks in the skin which occur in eczema can lead to infection
• Graft versus host disease (GvHD) which is discussed below can look very similar so its important to get your doctor to check the skin sooner rather than later if it becomes red and itchy.
Clicking on the heading above will take you to the skin GvHD section.
Skin infections are more common during the period after transplantation when the patient’s immune system is underactive. These might be bacterial (causing red hot skin called cellulitis), fungal (such as thrush or athlete’s foot) or viral. The commonest viral infections are herpes (cold sores or shingles), viral warts and a similar condition called molluscum contagiosum. Molluscum contagiosum produces round, skin coloured, persistent spots or lumps which last several weeks and can get quite inflamed (see Fig 3.).