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Winding Roads

What is Cutaneous Lymphoma?


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) 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) 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.


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