Cutaneous T-Cell Lymphoma is a form of cancer that causes immune system dysfunction that leads to skin health concerns. Like other forms of cancer, Cutaneous T-Cell Lymphoma can be deadly, especially if the condition goes untreated until it reaches the advanced stages. According to Dr. Howard Rubin of U.S. Dermatology Partners in Dallas, Texas, “Like other forms of cancer that we treat, Cutaneous T-Cell Lymphoma becomes more serious and difficult to manage when it goes untreated into the more advanced stages. It’s important for patients to know the warning signs and let their dermatologist know right away if they notice any of these symptoms.”
Keep reading to learn more about the warning signs of Cutaneous T-Cell Lymphoma and how it’s treated.
What is Cutaneous T-Cell Lymphoma?
Cutaneous T-Cell Lymphoma is typically referred to simply as CTCL. To better understand this type of cancer, it’s important to first understand the lymph system and how it impacts the body’s overall health.
The Lymph Nodes & Lymph System
Lymph is a liquid substance that the body produces to absorb bacteria and foreign matter that could otherwise damage the body. After lymph gathers these materials, it returns them to the lymph nodes to be removed from the body. The lymph nodes contain cells that help to remove bacteria and foreign matter from the body to keep us healthy and safe. The lymph system connects the lymph nodes to each other and to the other parts of the body. Through the lymph system, foreign matter is eventually processed through the liver and out of the body.
Lymphocytes
Lymphocytes are white blood cells. There are two main types: B-cells and T-cells. The role of white blood cells is to trigger an immune response and help the body to fight infection and stay healthy. The B-Cells produce antibodies in our blood that attack disease and infection. The T-Cells attack foreign matter that may injure the body. Working together, the B and T-Cells keep our bodies healthy.
Non-Hodgkin Lymphomas
Non-Hodgkin lymphomas, often referred to simply as NHLs, are cancers that impact the function of the immune system. The role of our immune system is to serve as a defense system for the body, protecting us against illness. Unfortunately, NHLs cause the immune system to malfunction and attack the body. These forms of cancer originate in the lymph nodes where cancerous lymphocytes (also called B or T cells) are produced. There are numerous different types of NHLs, and CTCLs are one group of these cancers.
Cutaneous T-Cell Lymphoma
CTCL is a type of NHL that produces malignant T-Cells. This type of cancer begins with a mutation in the white blood cells that causes them to attack the skin as if it were a bacteria or foreign body. According to Dr. Rubin, “It will likely come as no surprise that there are actually several types of CTCL. Depending on what type of CTCL a patient develops, the cancer can progress slowly or more quickly. Some types are unlikely to metastasize or spread to other parts of the body while other types are more aggressive, attacking surrounding tissues. To create an effective care plan, your dermatologist and a cancer specialist, called an oncologist, will work with you to determine the specific type of CTCL.”
The two most common forms of CTCL are mycosis fungoides and Sezary syndrome. All other forms of CTCL, including primary cutaneous anaplastic large cell lymphoma, lymphomatoid papulosis, granulomatous slack skin disease, pagetoid reticulosis, and subcutaneous panniculitis-like T-cell lymphoma, are considered to be extremely rare. All types of CTCL cancer are considered chronic and manageable. While CTCL isn’t usually life-threatening, it does require treatment to manage the symptoms and prevent the spread to other parts of the body.
While CTCL does adversely impact the skin, it’s not actually a skin cancer. Skin cancers begin in the skin cells whereas CTCLs develop in the lymph nodes and cause side effects that damage the skin. The malignant T-Cells produced by individuals with CTCL can accumulate in the skin, causing rashes. These rashes are often mistaken for more common skin conditions like eczema and psoriasis, so it’s important for patients who are concerned about CTCL to know the warning signs.
What are the Signs of CTCL & How is it Diagnosed?
CTCL causes cancerous T-cells to accumulate in the skin, leading to numerous warning signs like:
- Raised, thickened, or scaly patches of skin
- Skin redness or patches of skin that are paler than the surrounding areas
- Itchy skin and rashes
- Lumps or bumps on the skin
- Sores or ulcers on the skin
- Swelling of the lymph nodes
- Hair loss
Because CTCL is such a rare form of cancer, there are not screening tools specifically created for these types of cancer. During annual skin exams, dermatologists are likely to notice early warning signs of CTCL. If a dermatologist suspects lesions or rashes are indicative of CTCL, they may recommend a biopsy. This diagnostic tool requires the dermatologist to remove a small amount of skin tissue and examine it at the microscopic level. Additionally, the dermatologist will likely order blood tests and diagnostic imaging to ensure the most accurate diagnosis.
Treatment Options for CTCL
Your CTCL treatment plan will depend on the type and stage as well as your general health. There are two main types of treatment: skin-directed and systemic. As the names imply, skin-directed therapies target the effects of CTCL from the outside in, and systemic therapies are used to attack CTCL from the inside out.
Common Skin-Directed Therapies Include:
- Light therapy
- Topical steroids and retinoids
- Localized chemotherapy and radiation
Common Systemic Therapies Include:
- Oral retinoids
- Photopheresis
- Antibody therapies
- Interferon
- Immunotherapy
- Systemic chemotherapy
In most cases, patients receive a combination of topical and systemic treatments. In the very early stages, CTCL may be cured, but this is rare. For most patients, CTCL is a chronic form of cancer that requires maintenance therapies throughout their lifetime.
Visit U.S. Dermatology Partners
If you’re concerned about CTCL or any other skin health concerns, the U.S. Dermatology Partners team is here to help. Our knowledgeable dermatologists are proud to offer treatments that help patients with a wide range of dermatologic needs. If you’re ready to get started working with our team, simply fill out our online request form. One of our dermatology team members will be in touch soon.
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