Cutaneous (skin) lymphomas are cancers of lymphocytes (a type of white blood cells) that primarily involve the skin. Cutaneous lymphomas are classified based on whether they are cancers of B-lymphocytes (B-cell) or T-lymphocytes (T-cell).
Cutaneous T-cell Lymphoma (CTCL) is the most common type of cutaneous lymphoma, and typically presents with red, scaly patches or plaques on the skin. Itching is common, with less than 80% of people with CTCL reporting they have itch. CTCL often mimics eczema, psoriasis, or other chronic dermatitis, and because of this it’s common that the diagnosis of CTCL is delayed, sometimes by years or decades. Only a minority of people with CTCL develop advanced disease, with tumor formation, ulceration, involvement of lymph nodes, blood, and internal organs. Most people with CTCL have indolent (i.e. chronic, slowly growing) lymphomas – treatable, but not curable, and usually not life-threatening.
- Mycosis Fungoides is a type of Cutaneous T-cell Lymphoma. See Mycosis Fungoides for signs, symptoms and treatments.
- Sézary syndrome is a type of Cutaneous T-cell Lymphoma. See Sézary syndrome for signs, symptoms and treatments.
Signs and Symptoms
Lymphomas of the skin can be seen and felt. They can appear as:
- Papules (small, pimple-like lesions)
- Patches (flat lesions)
- Plaques (thick, raised or lowered lesions)
- Nodules or tumors (larger lumps or bumps under the skin)
The lesions are often itchy, scaly, and red to purple. The lymphoma might show up as more than one type of lesion and on different parts of the skin (often in areas not exposed to the sun). Some skin lymphomas appear as a rash over some or most of the body (known as erythroderma). Sometimes larger lesions can break open (ulcerate).
Along with skin problems, in rare cases lymphoma of the skin can cause general symptoms, such as:
- Unexplained weight loss
- Profuse sweating (enough to soak clothing), particularly at night
- Severe itchiness
Sometimes a skin lymphoma can reach the lymph nodes (small, bean-sized collections of immune cells), which can make them bigger. An enlarged lymph node might be felt as a lump under the skin in the neck, underarm, or groin area.
Most of these symptoms are more likely to be caused by other, less serious conditions. Still, if you have any of them it’s important to have them checked by a doctor so that the cause can be found and treated, if needed.
Skin-Directed Treatments for Skin Lymphomas
For many skin lymphomas (especially early-stage lymphomas), the first treatment is directed at the skin lesions themselves, while trying to avoid harmful side effects on the rest of the body. There are many ways to treat skin lesions.
- Radiation therapy
- Phototherapy (UV light therapy)
- Topical medicines
Whole-Body (Systemic) Treatments for Skin Lymphomas
Systemic treatments can affect the whole body. They are most useful for more advanced or quickly growing skin lymphomas. In some cases, a systemic treatment is combined with a skin-directed treatment or with another systemic treatment.
- Photopheresis (photoimmune therapy)
- Systemic chemotherapy
- Targeted and biologic therapies
- Systemic retinoids
- High-dose chemotherapy with stem cell transplant (SCT)
Your OHC doctor will discuss your options and help you determine the best care plan for you.