What are Cutaneous Lymphomas and how can they be treated?

Cutaneous lymphomas are a separate subset of non-Hodgkin’s lymphoma. They are actually cancers of lymphocytes (a type of white blood cells) that primarily involve the skin. Classification is based on the type of lymphocytes on the cutaneous lesions: B-lymphocytes or T-lymphocytes.

Cutaneous T-cell lymphoma (CTCL) is the most common type of cutaneous lymphoma, and typically presents with red, scaly patches or thickened plaques of skin that often mimic eczema or chronic dermatitis. Progression from limited skin involvement is variable and may be accompanied by tumour formation, ulceration, and exfoliation, which are accompanied by itching and complicated by infections. Advanced stages of cutaneous lymphomas are defined by involvement of lymph nodes, abnormal cells in the peripheral blood, and possibly the involvement of internal organs. Most cutaneous lymphomas are usually classified as chronic lymphomas, that can be treated and usually not life-threatening.

B-cell cutaneous lymphomas are a less common form of cutaneous lymphomas, accounting for about 20-25% of all cutaneous lymphomas. Non-Hodgkin B-cell cutaneous lymphomas originate in the skin’s B cells.

Systemic or nodular B-cell lymphomas may secondarily involve the skin, and when a skin biopsy shows B-cell lymphoma, it is very important to conform that the skin is the only organ involved, excluding a systemic lymphoma. The most common types of cutaneous B-cell lymphomas have slow progress and respond well to mild treatments.

Treatment for specific types of cutaneous lymphomas

Cutaneous lymphoma treatment is mainly determined based on the type of lymphoma, as well as its location and stage – the degree to which it may have spread in the body. However, other factors, such as the patient’s overall health, may also affect the treatment options. Discuss with your doctor for any question you may have about the recommended treatment plan.

Below some of the treatments are listed:

Topical therapies:

  • Phototherapy with Ultraviolet (UV) light (either UVB or UVA light in combination with medicines called psoralens; this treatment is known as PUVA)
  • Topical chemotherapy with BCNU or nitrogen mustard
  • Topical corticosteroids, ointments or injections
  • Topical retinoids (vitamin A)
  • Topical immunomodulating drugs
  • Local radiation treatments if there is only one or a few lesions
  • Electron beam therapy if the lesions cover most of the skin.

Sometimes different treatment methods may be combined.

Systemic treatments:

  • Retinoids taken by mouth
  • Targeted drugs
  • Photopheresis
  • Immunomodulators

In addition, Surgical Excision and Radiation Therapy may be also considered as treatment options.