The Skin Lymphoma
The Cutaneous Lymphoma Foundation - interview with Susan Thornton, CEO.
What is Lymphoma of the Skin?
Lymphoma is cancer of the immune system. This disease begins in lymphocytes.
Lymphocytes are natural killer cells named also white blood cells. They are part of our immune system.
You’ll find most of the lymphocytes in lymph nodes, bone marrow, skin and spleen.
There are many forms of lymphoma. However, when this disease starts only on the skin it is a skin lymphoma. It’s also named cutaneous lymphoma, or non-Hodgkin lymphoma.
The Causes of Skin Lymphoma
At first, causes of skin lymphomas are DNA changes, which occur when we age. This disease happens more often in elderly patients, and it isn’t contagious.
Another cause is connected to our immune system. Patients with weakened immune system like, patients after organ transplants, HIV infection, or because of inherited conditions may develop faster the disease.
The Symptoms of Skin Lymphoma
If you notice any persistent change in your skin, a sore place, a raised or growing lesion, it may look sometimes like an eczema or infection, please consult your doctor or dermatologist ASAP. This is always the best strategy.
Other symptoms are:
- Soaking sweating at night
- Deeply felt itchiness
- Unusual weight loss
- Feeling fatigued, often tired, and having less energy
The Types of the Skin Lymphoma
There are two types of this disease, T-cell and B-cell skin lymphomas. T-cells are skin associated cells. B-cells have specific protein on their surface. It is called B-cell receptor.
The average age of the patients of skin lymphoma is over fifty. More than 60% of those who suffer from this disease are men. A biopsy is needed in all cases to diagnose this disorder.
An Example of T-cell Lymphoma
T-cell Skin Lymphomas
- Mycosis fungoides (MF) – this is most common skin lymphoma. The visible symptom is a patchy, often extremely itchy, reddish lesion on the skin. It grows faster by older patients.
- Sezary disease develops often from MF, the mycosis fungoides lymphoma. In this case, the whole skin is involved instead of few patches. The skin is red and devilishy itchy. This lymphoma spreads faster and is more aggressive than MF.
- Anaplastic large-cell lymphoma (ALCL) starts with only one, usually small tumor and it won’t spread beyond the skin. For the patients, there is an exceptionally strong chance of recovery.
- Lymphomatoid papulosis is benign and slow growing. It starts as pimple-like lesions that may develop an ulcer in the middle. There is sometimes no treatment needed. Younger people and men get this disease more often.
- Subcutaneous panniculitis-like T-cell lymphoma is to find in the deepest layers of the skin, where a small lump can form. It grows slowly and has a high likelihood of recovery.
- Primary cutaneous peripheral T-cell lymphoma forms four different types of the disease. All of them are characterized by lesions, widespread patches, and tumors. These lymphomas are to a great extent hard to cure.
Primary Cutaneous Follicle Center B-cell Lymphoma
Primary Cutaneous Mariginal-zone B-cell Lymphoma
B-cell Cutaneous Lymphoma
- Primary cutaneous follicle center lymphoma, this is most frequently B-cell skin disorder in middle aged adults. This tumor of the skin requires a longtime (years) to develop and does have a good forecast of recovery. It presents itself mostly on the upper body or scalp as pink, rounded lumps, or plaques.
- Primary cutaneous marginal zone B-cell lymphoma is the second most common form of the B-cell skin diseases. It develops slowly, at any age, and is actually often curable. The look of lesions or bumps is reddish or purple. This lymphoma may be connected to borreliosis, a Lyme disease spread by ticks.
- Primary cutaneous diffuse large B-cell lymphoma, leg type, aggressive, rapidly growing, large, red lesions or open sores. They appear usually on lower legs and more often by aging women than men.
- Primary cutaneous diffuse large B-cell lymphoma, other is a very seldom disease, and it's not limited only to the skin, it can also appear within of blood vessels.
Experience Report of a Patient - B-cell Lymphoma
Diagnostic Challenges in Cutaneous T-Cell Lymphoma
How to Find out if the Pathological Change of Skin is a Lymphoma?
- Blood test - the complete blood count CBC
- Blood chemistry test
- Biopsy – a part of the skin, or even the whole tumor, will be removed for a test in a laboratory.
- Lymph node biopsy
- Bone marrow biopsy might be needed – taken from the hip or breast bone.
- Lumbar puncture – to find out if lymphoma cells have reached the brain – this test is needed in some cases
- Chest x-ray may be needed because of lymph nodes
- MRI scan – magnetic resonance imaging
- Ultrasound to look at the lymph nodes
- CT scan – computed tomography
- PET scan – positron emission tomography – can help to diagnose the lymph nodes
About B-cell Lymphoma
The Treatment of Skin Lymphoma
- Drugs applied directly to the skin, also chemotherapy on the skin, in the form of gel, ointments, or crèmes
- Radiation therapy
- Electron beam therapy (EBT)
- Chemotherapy, or high-dose chemotherapy with stem cell transplants SCT
- Drugs related to vitamin A - retinoids
- UV light therapy - uses light to kill cancer cells in the skin
- Photoimmune therapy
- A new family of biological and skin lymphoma targeted drugs (antibodies, inhibitors, and interferons) less aggressive than chemotherapy
- Tacrolimus – the new drug is applied directly to the skin and affects lymphocytes
- Aminolevulinic acid (ALA) – it’s photodynamic therapy (PDT) and is only useful in early stages of skin lymphomas
- Lymphoma vaccines to create an immune reaction to cancer.
Skin Lymphoma: The Illustrated Guide by Lorenzo Cerroni, Kevin Gatter...
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© 2012 Maria Janta-Cooper