Advancing the use of 'Welam's sign' as a prognostic marker in patients with cancer.

摘要

We read with great interest your recent article in the International Journal of Palliative Nursing regarding 'Welam's sign'. We have noticed, in practice, that some patients do develop the rash you describe and had made an association with a poor outlook.We had thought that the rash must have been associated with altered clotting function, and in the absence of other possible causes of a non-blanching rash, could have been related to disseminated intravascular coagulation reportedly present in 10% of cancer patients (Maxson, 2000), which in the presence of advanced cancer is considered likely to be a terminal event (Bick et al, 1999).