Types of Cutaneous T-Cell Lymphomas

Around 5% to 10% of non-Hodgkin lymphoma (NHL) cases are cutaneous T-cell lymphoma—an uncommon cancer that originates in white blood cells called T cells. While healthy T cells aid the immune system, cutaneous T-cell lymphoma causes T cells to attack the skin, leading to skin abnormalities and uncomfortable symptoms like itchiness and open sores.

There are two main subtypes of cutaneous T-cell lymphoma:

Mycosis Fungoides (MF)

The most common subtype of cutaneous T-cell lymphoma, Mycosis Fungoides is a chronic, slow-growing disease that is characterized by cancerous T-cell lymphocytes that affect skin.

Symptoms

The symptoms of Mycosis Fungoides may vary significantly from patient to patient. However, most cases involve unusual changes in skin, such as:

• Reddening of more than 80% of the skin (erythroderma)
• Skin ulcers, often with open sores
• Raised, thickened skin lesions that can be itchy (plaques)
• Discolored or red patches that may appear scaly
• Tumors or nodules beneath the skin

Treatment

There is no cure for Mycosis Fungoides. However, this cancer is often diagnosed in an early stage, and many patients are able to live relatively symptom-free for several years—sometimes decades—with prompt treatment.

Mycosis Fungoides does not spread (metastasize) beyond the skin in the majority of cases. Because of this, symptoms can often be effectively treated with skin-directed therapies, such as:

• Corticosteroid ointments or gels
• Topical retinoids
• Immune-stimulating creams
• Light therapies
• Topical chemotherapies
• Local radiation therapy

Systemic therapies that reach the bloodstream may be recommended to patients with advanced Mycosis Fungoides or whose symptoms do not improve with skin-directed therapies alone. Such treatments include targeted therapies and immunotherapies.

Sezary Syndrome (SS)

Sezary Syndrome is characterized by cancerous T cell lymphocytes in the blood. There is some debate over whether Sezary Syndrome is actually advanced-stage Mycosis Fungoides, but these diseases are most often viewed as separate conditions.

Symptoms

Most symptoms of Sezary Syndrome involve the skin. Common symptoms include:

• Reddening of more than 80% of the skin (erythroderma)
• Intense skin itchiness, often with extensive red rashes
• Cracked and thick skin on the hands or feet (keratoderma)
• Tender or swollen lymph nodes
• Changes in nails, hair or eyelids
• Frequent staph infections
• Commonly feeling cold due to the skin’s loss of temperature control

Treatment

There is not yet a cure for Sezary Syndrome. Unlike Mycosis Fungoides that can usually be addressed through topical treatments alone, Sezary Syndrome typically requires both skin-directed and systemic therapies to effectively control symptoms. Many treatment plans include a combination of:

• Retinoids
• Light therapy
• Radiation therapies
• Systemic or topical chemotherapy

Several research initiatives are currently devoted to improving treatment options for people with Sezary Syndrome, particularly in the field of immunotherapy.

Our approach to cutaneous T-cell lymphomas

Moffitt Cancer Center is home to a multispecialty team that focuses exclusively on the evaluation and treatment of hematological diseases. Patients in our Malignant Hematology Program and Cutaneous Oncology Program benefit from the combined expertise of medical oncologists, radiation oncologists, hematologists, pathologists and other experts who possess a unique level of experience addressing uncommon lymphomas like Mycosis Fungoides and Sezary Syndrome. Working together, our team creates individualized treatment plans for each patient and refines them as necessary to achieve more positive outcomes and improved quality of life for those we serve.

Moffitt also leads the charge in skin lymphoma research. Here, eligible patients can participate in trailblazing clinical trials and be among the first to receive new treatments for cutaneous T-cell lymphoma. Thanks to our efforts, Moffitt is recognized as a Comprehensive Cancer Center by the National Cancer Institute.

If you would like a second opinion regarding a cutaneous T-cell lymphoma diagnosis or wish to consult with a Moffitt oncologist about your symptoms, call us at 1-888-663-3488 or complete a new patient registration form online.