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Cutaneous T-cell Lymphoma (CTCL)

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Updated April 30, 2014

What is Cutaneous T-Cell lymphoma?:

Cutaneous T-Cell Lymphoma (CTCL) is the name given to lymphoma of the skin. It arises from T-cells, a type of lymphocyte or white blood cell. It is not a single disease, but a group of different lymphomas that affect the skin primarily. These include Mycosis fungoides, Sezary syndrome, Reticulum cell sarcoma of the skin and a number of other rare lymphomas.

How does lymphoma affect the skin?:

Lymphoma commonly involves lymph nodes. But lymph cells or lymphocytes are present in all organs of the body. Some T-cells naturally migrate to the skin for protection against infection. The cancer cells of cutaneous T-cell lymphoma also migrate to the skin. Most of the features of CTCL are related to lesions they produce on the skin.

Who is affected by CTCL?:

Cutaneous T-cell lymphoma is a rare variety of Non-Hodgkin Lymphoma (NHL), accounting for only about 1 in 40 newly diagnosed NHL patients. It affects men more commonly than women. Individuals affected are usually in their fifties or sixties. Children are rarely affected. There has been a striking increase in the number of individuals affected by skin lymphoma over the last 3 decades.

What causes Cutaneous T-cell lymphoma?:

Not much is known about the cause of CTCL. Unlike some other types of lymphomas, there is no association with known viruses. Research is underway to throw more light on the cause of this illness.

What are the symptoms of skin lymphoma?:

The first symptoms of skin lymphoma are dry scaly skin, a red rash and itching. The rashes are more common in areas that remain covered with clothes. Some individuals may first notice red or dark patches on the skin. These symptoms are not specific for lymphoma and most people are often first treated for more common skin conditions before lymphoma is suspected.

As the disease progresses, the red patches may become elevated – these are called plaques. Plaques may later turn into nodular or bumpy tumors. In advanced disease, ulcers can develop over these lesions. Disease may also spread to the nodes or other organs.

How is cutaneous T-cell lymphoma diagnosed?:

A skin biopsy is required to diagnose lymphoma of the skin. The biopsy sample is seen under the microscope to identify lymphoma cells. A number of other tests including tests for lymphoma markers (immunohistochemistry) and lymphoma genes are required to find out the type of lymphoma. CT scans or other imaging tests may be done to locate the extent of the disease.

Treatment of cutaneous T-cell lymphoma:

Treatment of skin lymphoma is quite different from that of most other lymphomas. The treatment strategy depends on the extent of skin involvement, the type of skin lesion and the involvement of nodes or other body organs.

Many types of treatment are used:

  • Chemotherapy agents applied on the skin
  • Total skin electron beam therapy – a type of radiation treatment
  • Psoralen and ultraviolet A rays
  • Ultraviolet B rays
  • Bexarotene – both as a gel as well as tablets
  • Denileukin Difitox
  • Interferon alpha
  • Chemotherapy by injections or pills

For details, see the article Cutaneous T-cell Lymphoma Treatment.

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