Cutaneous 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)
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 more 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.
CUTANEOUS B-CELL LYMPHOMAS (CBCL)
Cutaneous B-cell lymphomas (CBCL) make up about 20-25% of all cutaneous lymphomas, and are cancers that develop from skin-based B-cells. There are 3 main types of CBCL; primary cutaneous follicle center (“follicular”) lymphoma, primary cutaneous marginal zone (“MALT”) lymphoma, and primary cutaneous diffuse large B-cell (DLBCL, “leg type”) lymphoma. Primary cutaneous follicle center and primary cutaneous marginal zone lymphomas are the most common forms of CBCL, and are slow growing or indolent types that respond well to mild treatments. Systemic or nodal B-cell lymphomas can secondarily involve the skin, and when a skin biopsy shows B-cell lymphoma it is very important to make sure that the lymphoma is truly coming from the skin and not from a systemic lymphoma that has spread to the skin.
For a more in depth overview, watch Cutaneous Lymphoma 101.
Many effective treatment options exist for cutaneous lymphoma. You and your health care team will determine the best course of treatment.
The goal of treatment for cutaneous lymphoma is to control the disease and give you the best quality of life possible with your skin disease. Depending on your disease and stage, treatment options can include topical creams or ointments, phototherapy (light therapy), pills, infusion (intravenous) therapies, or radiation therapy. The purpose of treatment is to relieve symptoms such as pain, itching, burning, and redness; improve patches, plaques, or tumors to minimize the chance of infection; and reduce the number of abnormal T-lymphocytes in the blood (for Sézary syndrome).