Cutaneous T-Cell Lymphoma (CTCL)
Cutaneous T Cell Lymphoma (CTCL) is a rare type of
lymphoma caused by cancerous growth of T-cells in the skin. It is most common
in adults between 40 and 60 years of age.
There are a few sub-types of CTCL, the most common
Large areas of skin or lymph nodes are affected.
People with this lymphoma may have redness of the entire skin surface and
tumour cells which circulate in the bloodstream. This type of CTCL often
follows an aggressive course.
The general name given to the other types of CTCL
when the blood is not affected. Often, several years of eczema-like skin
conditions occur before the diagnosis is finally established. In advanced
stages, the lymphoma can spread to lymph nodes and other organs.
What are the symptoms?
CTCL can appear as small, raised, red patches on
the skin, often on the breasts, buttocks, skin folds and face. These patches
often look similar to eczema or psoriasis and may be associated with hair loss
in the affected area.
Patients in later stages may have ulcerating
tumours that appear on the skin. Lymph nodes in the affected region may also be
The diagnosis is made by skin biopsy of the area of
affected skin. In the early stages of mycosis fungoides, biopsy may be
difficult to interpret, and the correct diagnosis can only be made after
observing the person over time.
How is it treated?
therapies are used to treat CTCL. They include:
PUVA consists of a medicine called psoralen plus
ultraviolet A (UVA) light. Psoralen makes the skin more sensitive to the
healing effects of the UVA light. The treatment is similar to sitting under a
sunlamp and may be given several times a week and is generally used when the
lymphoma is over large areas of the skin.
Ultraviolet B (UVB) light slows the growth of the
cancerous cells in the skin. This treatment does not include the use of a
medicine to make the skin more sensitive. Treatment may be given several times
Local radiation may be used for early-stage CTCL if
only one or two small areas of skin are affected. Radiotherapy may also be used
to treat the entire surface of the skin if the CTCL is more widespread. This type
of radiotherapy is called total skin electron beam treatment. It is only given
once and then may be followed up with further PUVA treatments if needed.
Chemotherapy medicines may be applied directly to
the skin in the form of an ointment. Intravenous chemotherapy may be used if
the CTCL is more advanced.
Monoclonal Antibodies and Targeted Therapies:
Monoclonal antibodies and targeted therapies.
Monoclonal antibodies in combination with chemotherapy medicines and targeted
therapies are also available for patients with CTCL.
Interferon is a naturally occurring protein in the
body and is an important part of a healthy immune system. A synthetic form of
interferon can be injected under the skin to help boost the immune response and
fight the CTCL.
This treatment is used particularly for Sezary
syndrome. It involves passing the person’s blood through a machine where it is
exposed to ultraviolet light and a medicine before returning it back to the
patient. This procedure takes around 3 hours to complete and can be given every
month, every fortnight, every week or more frequently depending on the person's
skin and their response to treatment.