Cutaneous T-cell lymphoma: Causes

Cutaneous T-cell lymphomas are a group of diverse and complex cancers that develop in cells found in the skin called T-cells

What causes cutaneous T-cell lymphoma is still a bit of a mystery.

What causes cutaneous T-cell lymphoma?

Our skin contains about 20 billion T-cells. These cells make up our first line of defense against harmful viruses, bacteria, and other invaders. When cancer begins in some of these T-cells, people develop a type of cancer called cutaneous T-cell lymphoma, also called CTCL.

Exactly why this cancer develops is still a bit of a mystery.

Research suggests that a person’s genes, immune system, or exposure to certain chemicals may play a role.

Scientists have found that people who get this type of cancer often have changes in certain genes. When genes change (or mutate), the changes can cause healthy genes to become cancerous. More research is needed to know if this plays a direct role in causing cutaneous T-cell lymphoma.

The immune system may play a role. It’s possible that something in a person’s immune system causes long-term inflammation. This long-standing inflammation could explain why T-cells turn into cancer cells.

It’s also possible that toxins you’re exposed to play a role. For example, glass formers, potters, and people who work in the wood industry have a higher risk of developing the most common type of cutaneous T-cell lymphoma, mycosis fungoides (my-co-sis fuhng-goi-des). Cancer-causing substances that these people work with may play a role.

Cancer records also suggest that cutaneous T-cell lymphoma is more common in people who work with machine cutting oils.

Scientists are also looking at toxins like Agent Orange. This is a plant-killing mixture that was used during the Vietnam War. Many Vietnam Veterans were exposed to it. More studies are needed to know whether there is a link between Agent Orange and developing cutaneous T-cell lymphoma.

Who gets cutaneous T-cell lymphoma?

Cancer records show that more people are developing these cancers. This increase may be due to advances made in diagnosing the different types of cutaneous T-cell lymphoma.

Today, Black people have the highest risk of developing cutaneous T-cell lymphoma. Black people also tend to develop this cancer at an earlier age. Black Americans and Hispanic women are more likely to develop mycosis fungoides, the most common type of this cancer, before they turn 40.

We also know that:

• Men are twice as likely as women to develop these cancers.

• The risk of developing cutaneous T-cell lymphoma increases with age.

• Most people are diagnosed when they are in their 50s or older.

• Adults in their 20s, 30s, and 40s get these cancers.

• Cutaneous T-cell lymphoma is rare in children and teenagers.

Having an increased risk doesn’t mean that you’ll get one of these cancers. Likewise, people who don’t have any known risks can develop cutaneous T-cell lymphoma.

Anyone who thinks they may have signs of cutaneous T-cell lymphoma on their skin, should see a dermatologist for a diagnosis. No one knows your skin better than a board-certified dermatologist.

To find out how dermatologists diagnose this cancer, go to Cutaneous T-cell lymphoma: Diagnosis and treatment.

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References
Baggot M, Stadler R. “Cutaneous lymphoma.” In: Kang S, et al. Fitzpatrick’s Dermatology. (ninth edition) McGraw Hill Education, United States of America, 2019:2072-6.

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

Geller S, Lebowitz E, et al. “Outcomes and prognostic factors in African American and black patients with mycosis fungoides/Sézary syndrome: Retrospective analysis of 157 patients from a referral cancer center.” J Am Acad Dermatol. 2020;83(2):430-9.

Hinds GA, Heald P. Cutaneous “T-cell lymphoma in skin of color.” J Am Acad Dermatol. 2009 Mar;60(3):359-75; quiz 376-8.

Pinter-Brown LC, Schwartz RA, (Besa EC, editor) “Cutaneous T-Cell Lymphoma.” Medscape. Last updated 12/22/2021. Last accessed 5/23/2023.

Pulitzer M.” Cutaneous T-cell Lymphoma.” Clin Lab Med. 2017 Sep;37(3):527-46.

Written by:
Paula Ludmann, MS

Reviewed by:
Aaron R. Mangold, MD, FAAD
Elan M. Newman, MD, FAAD
Rajiv Nijhawan, MD, FAAD
Brittany Oliver, MD, FAAD

Last updated: 8/3/23