Cutaneous Lymphoma Clinic

Cutaneous lymphoma describes a set of cancers of immune system cells that manifest in the skin. The UI Health Care Cutaneous Lymphoma Clinic specializes in the diagnosis, treatment and management of these rare types of cancer.

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Cutaneous lymphoma is a cancer that can affect two types of white blood cells (lymphocytes) — T-cells and B-cells — that help your body’s immune system fight cancer. However, unlike other types of lymphomas, such as those that originate in the bone marrow or other lymphatic tissues, this cancer inhabits the T-cells or B-cells in the skin.

University of Iowa Health Care has established a multidisciplinary Cutaneous Lymphoma Clinic that offers the best options for treatment and disease management. Our specialists include dermatologists, oncologists, radiation oncologists, pathologists, researchers, and others who bring knowledge and skills to understanding and caring for each patient.

Cutaneous lymphoma symptoms and diagnosis

Cutaneous T-cell lymphoma is a rare cancer that affects fewer than one out of 100,000 people per year. This cancer is somewhat difficult to diagnose because some of its primary symptoms, such as a rash and itchiness, can easily be confused for symptoms of other conditions like eczema or psoriasis. Cutaneous B-cell lymphoma often presents as raised bumps. It is not unusual for patients to have cutaneous lymphoma for several years without understanding the real cause of their lesions.

Symptoms

Raised, itchy rash
Skin lesions (patches or plaques) in areas typically covered by a bathing suit and not generally exposed to the sun
Skin patches that look red, gray, brown or pink (may be harder to see on Black or brown complexions)
Lighter pigmented patches of skin (may be easier to see on Black or brown complexions)
Lesions may be solitary or cover several parts of the body
In some cases, hair loss (alopecia) and/or thickening of the skin on the palms of the hands and soles of the feet
In some cases, lesions may be thicker, nodular, and tumor-like

If you have symptoms like these that have not responded to long-term treatment, a visit with a UI Health Care specialist in the Cutaneous Lymphoma Clinic may help you get a more accurate diagnosis.

Diagnosis

There are several different types of cutaneous lymphoma, but they are primarily categorized by the type of white blood cell affected. The most common types of cutaneous T-cell lymphoma are mycosis fungoides and Sézary syndrome.

A little less than 25% of cutaneous lymphomas originate from B-cells.

UI Health Care physicians use a combination of methods to diagnose cutaneous lymphoma. They use detailed patient histories, blood tests, CT scans, and skin biopsies to help pinpoint if cancer is present and what type it is.

What causes cutaneous lymphoma?

While researchers don’t know what causes cutaneous lymphoma, they believe the answer may be a combination of factors, including a genetic component, accumulating cell mutations, and environmental factors. Even though this cancer arises in the skin, sun exposure — a major risk factor for skin cancer — is not a known risk factor for cutaneous lymphoma.

Who is at risk for developing cutaneous lymphoma?

While anyone can get cutaneous lymphoma, people in these groups are at highest risk for the disease:

Black people
People over age 50
People assigned male at birth

Cutaneous lymphoma treatment from UI Health Care

UI Health Care cancer specialists will assess the extent of body involvement, the degree of severity, and the patient’s level of discomfort with their symptoms. Cutaneous lymphomas can present across a wide spectrum of severity, and it is the combination of degree of body involvement, symptom burden, and differing risks and logistics of treatment types that determines a final management plan.

Treatments may include:

Skin-directed therapies such as topical creams/ointments or skin lesion injections
Phototherapy — Ultraviolet (UV) light directed at the affected skin to destroy diseased cells
Extracorporeal photopheresis (ECP) — A special device that directs UV light at the blood to destroy diseased cells
Radiation therapy
Chemotherapy
Targeted therapy
Immunotherapy
Bone marrow transplant

UI Health Care physicians in the Cutaneous Lymphoma Clinic will work closely with you to balance your quality of life with the most effective treatment option.

What to expect

In most cases, cutaneous lymphoma can be treated as a chronic illness. Symptoms may be very mild (one or a few spots or rashes that are mildly itchy) or more bothersome (widespread rashes that are itchy or painful). Assessing your symptoms and overall health will help determine the best treatment. In some cases, successfully managing cutaneous lymphoma may be a more realistic goal than completely eliminating the cancer.

However, a small minority of patients may have cutaneous lymphoma that becomes aggressive and involves the blood or other organs. In these cases, your physician may recommend a bone marrow transplant to halt the disease.

You can be assured that specialists in the UI Health Care Cutaneous Lymphoma Clinic will provide comprehensive, personalized care to give you the most successful outcome possible.