Cutaneous T-cell Lymphoma

Cutaneous T-cell lymphoma (CTCL) is a disease that begins in T cells — a type of white blood cell that normally helps your immune system fight off infection.

In CTCL, abnormal T cells travel to the skin, causing red, scaly patches, plaques or raised bumps that can easily be mistaken for common skin conditions like eczema or psoriasis. Most people are diagnosed in their 50s or 60s, though CTCL can occur at any age and is slightly more common in men than women.

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Types of Cutaneous T-Cell Lymphomas

Fred Hutch Cancer Center physicians care for patients with all types of CTCL, including common and rare types.

Mycosis Fungoides

Mycosis fungoides is the most common type of CTCL. It is a low-grade lymphoma that primarily affects the skin and usually progresses slowly.

Learn More About Mycosis Fungoides

Sézary Syndrome

Sézary syndrome is an advanced form of CTCL where cancer cells are found in both the skin and the bloodstream. Because it travels through the blood, it affects the entire body and tends to be more aggressive than mycosis fungoides. While it can occur at any age, it usually affects men over 50.

Cutaneous Anaplastic Large Cell Lymphoma

Cutaneous anaplastic large cell lymphoma (ALCL) usually starts as a single tumor that is confined to the skin. It is less aggressive than systemic ALCL. Relapses, which often occur, are generally confined to the skin and are treated as a slow growing (indolent) lymphoma.

Subcutaneous Panniculitis-like T-cell Lymphoma

Subcutaneous panniculitis-like T-cell lymphoma is very rare. It causes nodules deep in the skin and while it is most often found in the legs, it can occur anywhere on the body. This slow growing cutaneous lymphoma affects people of all ages and both sexes equally.

Primary Cutaneous Peripheral T-cell Lymphoma

Primary cutaneous peripheral T-cell lymphoma includes three types of rare cutaneous lymphomas that don’t fit into any of the other categories, including:

  1. Primary cutaneous aggressive epidermotropic CD8+ cytotoxic T-cell lymphoma
  2. Cutaneous gamma/delta T-cell lymphoma, and
  3. Primary cutaneous CD4+ small/medium sized pleomorphic T-cell lymphoma 

Skin lymphomas that don't fall into any of these three categories are called primary cutaneous peripheral T-cell lymphoma, unspecified.

Lymphomatoid Papulosis

Lymphomatoid papulosis (LyP) is a skin condition with features that are similar to primary cutaneous anaplastic large cell lymphoma. While LyP is classified as pre-cutaneous T-cell lymphoma, it is a chronic skin condition that may come and go, even without treatment. The American Cancer Society does not classify it as a form of cancer.

Dr. Michi Shinohara

“There’s a lot of misinformation out there about this disease, so I find it rewarding to help patients understand what the condition is and how we can treat it. Most people live with CTCL for quite a long time, and I want to make sure those years are good years.”

— Dr. Michi Shinohara, dermatologist and co-director of the Fred Hutch Cutaneous Lymphoma Clinic

How CTCL is Treated

Depending on how much of the skin is involved, treatment options generally include:

  • Skin-directed treatments: Topical ointments, light therapy (phototherapy) or targeted radiation.
  • Systemic treatments: Oral or intravenous medications are often used if the disease advances beyond the skin.