Cutaneous lymphoma is a rare type of non-Hodgkin lymphoma that starts in the skin. It develops from lymphocytes, a type of white blood cell that normally helps to fight infection. Unlike lymphomas that start in the lymph glands, cutaneous lymphoma usually stays in the skin for a long time, and most types grow very slowly.
There are two main groups:
- Cutaneous T-cell lymphoma (CTCL), the most common group, which includes mycosis fungoides and the much rarer Sézary syndrome
- Cutaneous B-cell lymphoma (CBCL), which includes primary cutaneous follicle centre lymphoma and marginal zone lymphoma
Because early cutaneous lymphoma can look very like eczema or psoriasis, it can take time to diagnose. A rash that does not settle with the usual treatments, or that keeps changing, should be checked by a consultant dermatologist.
Cutaneous Lymphoma
Professor Rubeta Matin offers a dedicated extended consultation for patients newly diagnosed with, or suspected of having, cutaneous lymphoma.
She provides specialist skin expertise to the haematology and oncology teams at Oxford University Hospitals, and can coordinate with NHS lymphoma services where needed.
Symptoms of Cutaneous Lymphoma
What it can look like
Cutaneous lymphoma looks very different from one person to another, and early patches are often mistaken for eczema or psoriasis. There is no single typical appearance.
You can see examples, and read more about the condition, on these patient information websites:
The signs depend on the type and stage of lymphoma. Many people only have mild skin changes for years.
Common signs include:
- Flat, scaly, red or pink patches, often on skin covered by clothing, such as the buttocks, hips, thighs and trunk
- Thicker, raised plaques that may itch
- Lumps or nodules in the skin
- In B-cell lymphoma, pink, red or purple lumps, often on the head, neck, trunk or legs
- Rarely, widespread redness of the skin with intense itching, as in Sézary syndrome
Patches may come and go, and may improve in the sun. Many other skin conditions cause similar changes, so these signs do not necessarily mean lymphoma.
Causes of Cutaneous Lymphoma
The cause of cutaneous lymphoma is not known. It is not infectious, so it cannot be passed on to other people, and it is not usually inherited.
It happens when lymphocytes in the skin start to multiply in an uncontrolled way. Cutaneous lymphoma is more common in people over 50, and slightly more common in men, but it can occur at any age.
Diagnosis of Cutaneous Lymphoma
Diagnosis is based on a careful skin examination and one or more skin biopsies.
A small sample of skin is taken under local anaesthetic and examined under the microscope, with special tests on the cells. Because early cutaneous lymphoma can look like other conditions, biopsies sometimes need to be repeated over time before a firm diagnosis can be made.
Professor Matin does not take biopsies herself. If you need one, it is done at Derma by another of our consultant dermatologists or, if you are paying for yourself, by our dermatology nurse Aleesa Dela Vega. If you are using medical insurance, the biopsy needs to be done by a consultant.
Blood tests, and sometimes scans, may be needed to check whether the lymphoma is confined to the skin. Cases are usually reviewed by a specialist skin lymphoma team.
Treatment at Derma for Cutaneous Lymphoma
Treatment depends on the type and stage of the lymphoma. Most people with early-stage disease have treatment directed at the skin, which can control the condition well for many years.
Treatments include:
- Strong steroid creams or ointments
- Phototherapy, such as narrowband UVB, which is available at Derma
- Other treatments applied to the skin
- Radiotherapy for individual patches or lumps
More advanced disease may need tablets, injections or other treatments given by a specialist lymphoma centre. Your consultant will discuss the options with you and coordinate your care with NHS specialist teams where needed.
Long-term follow-up is important, so that any changes can be picked up early.
Frequently Asked Questions
Is cutaneous lymphoma a skin cancer?
It is a type of lymphoma, a cancer of the immune system, that starts in the skin. It behaves very differently from common skin cancers such as basal cell carcinoma or melanoma, and most types grow slowly.
Is it contagious?
No. Cutaneous lymphoma cannot be passed on to other people.
Can it be cured?
Some types can be cleared completely. Others, such as mycosis fungoides, are usually controlled rather than cured, and many people live with the condition for many years with good quality of life.
How long is the extended consultation?
The extended consultation allows more time to review your history, examine your skin and agree a plan, including arranging any biopsy or tests. Please contact us for details.
Related Specialists at Derma
Professor Rubeta Matin
Consultant Dermatologist
General dermatology
Specialist interests in skin cancer and moles, skin disease in transplant and immunosuppressed patients, and cutaneous lymphoma.