Cutaneous Lymphoma

Cutaneous lymphomas are unique varieties of non-Hodgkin lymphoma that arise in the skin. Also called skin lymphomas, these rare cancers make up only about 5 percent of all non-Hodgkin lymphoma cases.

Specialized Evaluation, Sought-After Treatments

Harold C. Simmons Comprehensive Cancer Center, the only NCI-designated Comprehensive Cancer Center in North Texas, is home to a specialized, multidisciplinary team that expertly diagnoses and treats cutaneous lymphoma.

The region’s only cutaneous T-cell lymphoma referral center, UT Southwestern is unmatched in our ability to diagnose the many varieties of lymphoma and to target treatments to the specific variations of the disease – treatments that sometimes aren’t available anywhere else.

These treatments include many types of phototherapy (including the only UVA-1 phototherapy unit in the Southwest); total skin electron beam therapy; and photopheresis.

We also offer the most current evidence-based chemotherapy drugs, both skin-directed and systemic (whole-body); immunotherapy agents such as rituximab and brentuximab; and combination therapies.

In cutaneous lymphoma cases that require bone marrow transplantation, UT Southwestern has a track record of success. Recognized as one of the leading programs of its kind in the U.S., our Bone Marrow Transplant Program stands out among regional competition for treating hematologic malignancies (“blood cancers”) such as lymphoma.

In addition to our advanced cutaneous lymphoma treatments, UT Southwestern is at the forefront of conducting research into the causes of and cures for all types of lymphoma.

Whether our patients require aggressive treatment or a watch-and-wait approach, our cutaneous lymphoma team offers expert, patient-focused care. Our goal is to restore the overall well-being and appearance of every patient we treat.

Types

Cutaneous lymphoma is cancer of the white blood cells (lymphocytes) that mainly involve the skin. The type of lymphocytes affected determines which of the two main categories of cutaneous lymphoma is present.

  • Cutaneous T-cell lymphoma (CTCL) – Diagnosed when T lymphocytes are affected, CTCLs make up approximately 75 percent of cutaneous lymphoma cases.
  • There are two subtypes of cutaneous T-cell lymphoma: mycosis fungoides and Sezary syndrome, a leukemic variant of mycosis fungoides.
  • Cutaneous B-cell lymphoma (CBCL) – Diagnosed when B lymphocytes are involved, CBCLs comprise about 25 percent of cutaneous lymphoma cases.

Symptoms

Cutaneous lymphomas typically appear as skin lesions that may be scaly, itchy, and red to purple in color. These lesions can arise anywhere on the body – frequently on areas without sun exposure – and take one or more of these forms:

  • Small, pimple-like lesions (papules)
  • Flat lesions (patches)
  • Thick, lowered or raised lesions (plaques)
  • Lumps or bumps under the skin (nodules or tumors)

Some types of cutaneous lymphoma can manifest as a large rash called erythroderma.

Speak with your doctor if you experience symptoms of cutaneous lymphoma.

Diagnosis and Staging

Accurate, early diagnosis and staging of cutaneous lymphoma is crucial to providing the most effective treatments and helping our patients achieve the best possible outcomes.

UT Southwestern takes accurate diagnosis to the highest level with the help of specialized hematopathologists, who are pathologists uniquely trained to identify all types of cutaneous lymphoma.

Cutaneous lymphoma is diagnosed and staged with a combination of a physical examination; a review of the patient’s symptoms, health status, medical history, and family history; and tests that can include:

  • A tissue sample (biopsy) of the skin, which can detect cutaneous lymphoma cells in a suspicious lesion.
  • A lymph-node biopsy, which can detect cutaneous lymphoma cells in the lymph nodes.
  • Blood analysis, which evaluates and quantifies the types of blood cells and other components in the blood to help determine the stage of the disease.
  • Imaging studies, including magnetic resonance imaging (MRI), ultrasound, computed tomography (CT), bone scans, and positron emission tomography (PET) which help clinicians visualize tumors and perform guided biopsies and other procedures.
  • Bone marrow aspiration and biopsy, which can help determine whether cutaneous lymphoma has spread to the bone marrow.
  • Tests of heart and lung function help clinicians evaluate patient suitability for certain treatments.

Advanced Therapies, Compassionate Care

Treatment for cutaneous lymphoma depends on its type and stage, as well as on the overall health, preferences, and goals of the patient.

UT Southwestern’s cutaneous lymphoma specialists offer some of the most advanced treatments available. We’ll work with you to determine the most appropriate evidence-based treatment for your unique cancer.

In addition, our team members are sensitive to the emotional impact that skin cancers such as cutaneous lymphoma can have on patients’ lives, and we strive to minimize any visible reminders of the disease.

Cutaneous lymphoma treatments are divided into two broad categories:

Those that target only the skin, including:

  • Phototherapy (“UV light therapy”) – This advanced technology, which includes many types, such as UVA-1 phototherapy, uses ultraviolet light to treat cutaneous lymphoma and a number of other skin conditions.
  • Radiation therapy – This commonly used treatment has good cosmetic results because it causes minimal scarring.
  • Topical medications – These include topical chemotherapies such as nitrogen mustard.
The Phototherapy Center in the General Dermatology Clinic at UT Southwestern.
UT Southwestern's Phototherapy Center in the General Dermatology Clinic.

Those that can impact the entire body:

  • Total skin electron beam therapy (“electron beam radiation) – This sophisticated type of radiation therapy affects only the outer layers of the skin.
  • Photopheresis – Also known as photoimmunotherapy and extracorporeal photopheresis (ECP), this leading-edge treatment targets the white blood cells that cause disease.
  • Whole-body (systemic) chemotherapy
  • Immunotherapy drugs, including rituximab and brentuximab – These agents help the body fight cutaneous lymphoma and other diseases.
  • Systemic retinoids – Typically made with natural or synthetic vitamin A, these pills are used to treat a number of dermatologic conditions.
  • High-dose chemotherapy with bone marrow transplantation, also called stem cell transplantation

Cutaneous lymphoma patients also may be eligible to participate in clinical trials of promising new protocols aimed at improving diagnosis, treatment, and outcomes of the disease. Talk with your doctor to find out if a clinical trial might be right for you.

Our Team

The physicians who comprise UT Southwestern’s multidisciplinary cutaneous lymphoma team work together to expertly evaluate and treat all varieties of the disease.

Neil Desai, M.D.

Prapti Patel, M.D.

Syed Rizvi, M.D.

Heather Wickless, M.D., M.P.H.

Schedule an Appointment

To schedule a visit with a cutaneous lymphoma specialist at UT Southwestern’s facilities in Dallas or to learn more about our services, request an appointment or call 214-645-2400.