The most common type of blood cancer, which is developed in the white blood cells called lymphocytes, is known as lymphoma and can be classified as Hodgkin’s lymphoma or non-Hodgkin’s lymphoma, according to its characteristics.
It appears in different parts of the body, including the skin. Cutaneous lymphoma is a sub-type of non-Hodgkin’s lymphoma and can be originated both in B-cells or T-cells.
The lymphocytes are responsible for protecting the body against infections, but these cells reproduce and expand uncontrollably in lymphoma patients. The cells affected by the cancer travel to different parts of the body, forming a mass or tumor in locations like the lymph nodes. Cutaneous lymphoma can involve not only the skin, but also the blood, lymph nodes, and internal organs.
Cutaneous Lymphoma Development and Risk Factors
Cutaneous lymphoma can originate in either the B-cells or T-cells, the latter being the most common type and accounting for 75% to 80% of all cases of the disease, according to the National Institutes of Health (NIH).
Both cutaneous T-cell lymphoma (CTCL) and cutaneous B-cell lymphoma (CBCL) can affect the skin, lymph nodes, peripheral blood, and internal organs. They are usually slow-growing or indolent, which means they are chronic and not treatable, but also not life-threatening.
The causes for the development of cutaneous lymphoma are not totally understood, but there are risk factors that impact the probability of suffering from the disease. It is known that men are more likely to develop cutaneous lymphoma than women. Chances for the cancer increase after age 50. Having a weakened immune system, being exposed to certain infections and genetic mutations that occur in the body throughout the lifetime, also influence the probability of developing the disease.
Cutaneous Lymphoma Symptoms and Diagnosis
The first symptoms of the cutaneous lymphoma are usually visible because the disease starts by affecting the skin. Dry skin, itching, lesions on the skin, patches, bumps, red rashes and swollen lymph nodes are among the symptoms – which tend to be more noticeable as the disease progresses. When cutaneous lymphoma is not detected early, it could evolve into a more advanced stage. Then, the patient could experience unexplained weight loss, fever, profuse night sweats, and severe itching.
Despite being visible, the symptoms may be confused with other dermatological conditions and can make the diagnosis difficult.
In order to confirm or exclude the diagnosis of cutaneous lymphoma, physicians usually extract a sample of tissue to biopsy the skin. Less commonly, the lymph nodes are biopsied. Other exams may be required to analyze the extent and type of the cancer such as blood and imaging tests.
Treatment and Prognosis of Cutaneous Lymphoma
Treatment of the disease is designed to each patient’s and tumor’s characteristics and other factors including age, activity, stage and expansion of the disease, prior treatments conducted, and other health conditions like diabetes or heart disease.
According to the American Cancer Society: “the first treatment for many skin lymphomas is directed at the skin lesions themselves, while trying to avoid harmful side effects on the rest of the body. There are many ways to treat skin lesions.” These include surgery, which may be recommended when only one or a few skin lesions can be removed completely.
In addition or as alternative, radiation therapy can kill cancer cells with high-energy rays.
Phototherapy is a type of treatment that uses ultraviolet A (UVA) or ultraviolet B (UVB) light to kill cancer cells in the skin. It is particularly helpful in cases of less thick cutaneous lymphoma.
Topical medicines can be applied directly to the skin, specially in cases of early diagnosis. Topical medicine scan include corticosteroids, chemotherapy drugs, retinoids, and immune therapy.
Unlike other cancer treatments, when addressing cutaneous lymphoma, physicians often recommend the repetition of the successful therapies used previously. The main purpose of the cutaneous lymphoma treatments is to clear all patches, plaques or tumors, as well as decrease the amount of lymphocytes and relieve the patients from symptoms like itching, burning, pain and redness.
Currently, about 80% of patients diagnosed with cutaneous lymphoma survive particularly when early diagnosis is met with early treatment.
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