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Cutaneous T-cell lymphoma: Overview


What exactly is cutaneous T-cell lymphoma?

Cutaneous T-cell lymphoma (CTCL) is a rare type of blood cancer.

It begins in a type of white blood cell called the T-lymphocyte (T-cell). T-cells help prevent infections and other diseases.

As odd as it sounds, most T-cells are found in our skin. That’s because our skin is the first line of defense against disease. The surface of an adult’s skin contains about 20 billion T-cells. That’s nearly twice as many T-cells as found in other parts of the body.

There are many types of CTCL. More than half the people who develop CTCL will have one of the following types:

  • Mycosis fungoides

  • Sézary syndrome

Mycosis fungoides is the most common type of CTCL. This type tends to worsen very slowly. It can stay in its earliest stage, which often looks like rash, for years. In this stage, the cancer is often difficult to diagnose because it tends to looks like eczema or psoriasis. These conditions are much more common than CTCL.

Sézary syndrome is more aggressive. It can also look like eczema. Some people develop red and swollen skin over much of their body. Their skin may feel hot, sore, and extremely itchy.

The other types of CTCL are very rare.

Cutaneous T-cell lymphoma is rare

The most common type of Cutaneous T-cell lymphoma often looks like a rash and develops on skin that gets little sunlight.

Because CTCL is rare and often looks like eczema or another common skin disease, it can take time to get the diagnosis. Some people who have CTCL are referred to a dermatologist because it’s thought that they have a stubborn case of eczema or psoriasis.

If you are diagnosed with CTCL, you may receive care from a team of doctors and other health care specialists. This team may include a dermatologist, hematologist (doctor who diagnoses and treats blood diseases), oncologist (cancer doctor), and radiation oncologist (cancer doctor who specializes in using radiation to treat cancer).

Due to recent advances in treatment, many people diagnosed with CTCL live normal lives.


Image
Image used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.

References
Clark RA. “Skin resident T-cells: The ups and downs of onsite immunity.” J Invest Dermatol. 2010; 130(2): 362–70.

Habif TP, Campbell JL, et al. “Cutaneous T-cell lymphoma.” In: Dermatology DDxDeck. Mosby Elsevier, China, 2006: Card 131.

Jawed SI, Myskowski PL, et al. “Primary cutaneous T-cell lymphoma (mycosis fungoides and Sezary syndrome): Part I. Diagnosis: Clinical and histopathologic features and new molecular and biologic markers.” J Am Acad Dermatol 2014;70:205.e1-16.

Sahni D. “What’s new in cutaneous T-cell lymphoma.” In: Novel therapies for cutaneous malignancies: What's new and what's ahead.” 2018 Annual Meeting of the American Academy of Dermatology; 2018 February 16-20. San Diego, CA.

Wilcox RA. “Cutaneous T-cell lymphoma: 2017 update on diagnosis, risk-stratification, and management.” Am J Hematol. 2017 Oct;92(10):1085-1102.

Willemze R. “Cutaneous T-cell lymphoma.” In: Bolognia JL, et al. Dermatology. (second edition). Mosby Elsevier, Spain, 2008:1867-86.

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