Lesser Known Skin Cancers: Cutaneous T-Cell Lymphoma

Cutaneous T-cell lymphoma is a non-Hodgkin lymphoma that occurs when the white blood cells called T-cells grow and multiply uncontrollably. Although cutaneous T-cell lymphoma (CTCL) is a type of blood cancer, it commonly involves the skin.

Lymphoma is a general term that encompasses any cancer that starts in the cells of the immune system. Lymphomas are divided into two major types: Hodgkin lymphoma and non-Hodgkin lymphoma (NHL).1,2

How common is cutaneous T-cell lymphoma?

CTCL is a rare form of NHL, accounting for just 4% of all NHL. The annual age-adjusted incidence is approximately six cases per one million people. CTCL occurs twice as often in men than in women, and the rate of CTCL increases as a person ages, with the average age of onset between 50 and 60 years of age. While it is uncommon to occur in children, CTCL can affect people of any age.1,2

Symptoms of cutaneous T-cell lymphoma

In addition to its effects on the skin, CTCL can involve the blood, lymph nodes, and other internal organs. Common symptoms of CTCL include dry skin, severe itching, redness, rash, and swollen lymph nodes. Most people who develop CTCL experience only skin symptoms, but approximately 10% of those whose cancer progresses to later stages develop serious complications.

There are many variations in CTCL, but the two most common types are mycosis fungoides (MF) and SĂ©zary syndrome (SS). MF is more common, and symptoms include scaly patches, raised bumps (tumors), or thick, itchy plaques on the skin. SS is a more aggressive form of the disease and can cause symptoms such as red, itchy rashes, patches, or tumors. Some people with SS experience changes in their nails, hair, or eyelids, and many experience enlarged lymph nodes.1,2

How is cutaneous T-cell lymphoma diagnosed?

CTCL is diagnosed with a medical history, physical exam, and a skin biopsy. During the physical exam, a physician will palpate (touch) lymph nodes. Blood tests may be run, and some people have additional screenings, such as a chest x-ray, a computed tomography (CT) scan, a positron emission tomography (PET) scan, and/or a magnetic resonance imaging (MRI) scan.1,2

How is cutaneous T-cell lymphoma treated?

Treatment for CTCL is tailored to the individual patient based on their age, health, and the stage and extent of the disease, such as the amount of skin involved, the type of CTCL, and whether the cancer has spread to internal organs.

For MF, treatment may be local (directed at the skin) or systemic (involving the entire body). SS is a more systemic condition and is not usually treated with just skin-directed therapies.

Treatment options for CTCL include corticosteroids, retinoids, radiation therapy, chemotherapy, methotrexate, phototherapy (ultravoilet light therapy), biologic or immune therapies. For people with aggressive disease or whose disease does not respond to other treatment, an allogenic stem cell transplantation may be considered. Many people with CTCL achieve remission with proper treatment.1,2

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