What is cutaneous T cell lymphoma?
Cutaneous T cell lymphoma (CTCL) is a rare type of cancer that affects certain white blood cells, called T cells. Healthy T cells produce an immune response to ward off disease. With cutaneous T cell lymphoma, T cells mistakenly attack the skin, causing rashes, discoloration, itchy patches, lumps, and other symptoms. This type of non-Hodgkin lymphoma typically grows slowly and only impacts the skin but may spread to the lymph nodes or enter the bloodstream.
Penn Medicine’s dermatology team specializes in diagnosing and treating lymphoma of the skin. Working with experts from other disciplines, including hematologists and oncologists, our dermatologists provide complete care for your body. While there’s no cure for CTCL, treatments can lead to remission and make you feel more comfortable.
Types of cutaneous T cell lymphoma
The most common types of CTCL are mycosis fungoides and Sézary syndrome. While other types of cutaneous T cell lymphoma exist, they are exceedingly rare.
This type accounts for about 50 percent of CTCL cases, making it the most prevalent form of cutaneous T cell lymphoma. Mycosis fungoides (MF) symptoms often begin as a skin rash and may progress to include itchy, dry, or lumpy skin. Eventually, mycosis fungoides tumors may result.
Typically, this is a slow-growing cancer that affects the skin only. In some cases, MF transitions to the more serious Sézary syndrome, which is likely to impact lymph nodes and enter the bloodstream.
Less common than mycosis fungoides, Sézary syndrome occurs when a high concentration of cancerous T cells affects the skin, lymph nodes, and bloodstream. It often appears on widespread areas of the skin. This is a relatively fast-growing type of cutaneous T cell lymphoma that may require aggressive treatment.
Cutaneous T cell lymphoma symptoms
CTCL may initially look like other common skin disorders such as eczema, psoriasis, or chronic dermatitis. Most often it includes a lymphoma skin rash and some combination of red, dry, lumpy, scaly, mottled, or thickened skin. A dermatologist can assess these symptoms and determine whether you should be checked for cutaneous T cell lymphoma.
Specific symptoms may include:
- Skin patches that may be scaly and itchy, particularly on skin that’s not exposed to the sun
- Discolored patches of skin that may be red, pink, gray, brown, or lighter than the adjacent skin color
- Lumpy skin that forms small bumps that may transition to open sores
- Substantive lesions that are raised and thick (called plaques)
- Scaly and itchy rashes that extend over large areas of the body
- Enlarged lymph nodes
Causes of CTCL
The causes of cutaneous T cell lymphoma aren’t clear. Genetic factors or immune system disorders may play a role in developing the disease. While CTCL is rare, it may be more prevalent among people who are:
- Older than 50 years of age
- Assigned male at birth
- Black
- Have immune systems that are weakened or compromised
Diagnosing cutaneous T cell lymphoma
CTCL can be challenging to diagnose because its symptoms mimic those of other skin conditions. Your dermatologist will perform a physical exam and will carefully look for rashes, lumps, discoloration, open sores, and other characteristics of the disease. They’ll take your medical history and ask about the severity of your symptoms. They may recommend blood or imaging tests to complete their evaluation. Additional tests can rule out whether lymphoma has spread to other parts of the body besides the skin.
Cutaneous T cell lymphoma treatment
Your doctor will recommend treatments based on your stage of cancer (early or late stage) to relieve symptoms and help prevent the cancer from spreading. Early-stage treatment often includes topical creams and other direct skin treatments that stimulate immune responses. In later stages, skin treatments may be combined with oral medications and other cancer therapies.
Leaders in cutaneous T cell lymphoma treatments
Our cutaneous lymphoma specialists at Penn Medicine are national leaders in finding new and more effective ways to treat skin lymphoma. We have a long history of research coupled with participation in numerous clinical trials, giving us a unique perspective to offer the latest medications and protocols. Our innovative approach to Sézary syndrome using multiple modes of treatment has produced transformational results for those living with the disease.
As the largest referral program for cutaneous T cell lymphoma in the nation, our dermatology specialists are sought after for their expertise in treating this rare condition. We routinely evaluate hundreds of new patients a year and manage thousands of outpatients annually. Based on this experience, we can diagnose CTCL with accuracy and provide well-rounded care to help you manage the disease successfully and feel better.