Skin Diseases & Skin Care

Editorial

Cutaneous T-cell lymphoma (CTCL) is a rare type of cancer that begins in T cells, which are white blood cells (T lymphocytes). Normally, these cells assist your body's immune system in fighting germs. T cells in cutaneous T-cell lymphoma develop abnormalities that cause them to attack the skin.

Cutaneous T-cell lymphoma can result in rash-like skin redness, slightly raised or scaly round patches of skin, and, in rare cases, skin tumours.

There are several types of cutaneous T-cell lymphoma. Mycosis fungoides is the most common type. Sezary syndrome is a less common type that causes widespread skin redness. Some cutaneous T-cell lymphomas, such as mycosis fungoides, progress slowly, whereas others are more aggressive.

Cutaneous T-cell lymphoma is one of several types of lymphoma that are referred to collectively as non-Hodgkin's lymphoma.

Subtypes of CTCL

CTCL refers to a wide range of disorders with varying symptoms, outcomes, and treatment options:

Mycosis fungoides (MF): Mycosis Fungoides (MF) is the most common type of CTCL, accounting for roughly half of all CTCLs. MF can manifest differently in each patient, with skin symptoms such as patches, plaques, or tumours.

Sézary syndrome: Characterised by the presence of lymphoma cells in the blood, patients with Sézary Syndrome frequently present with extensive thin, red, itchy rashes on the skin.

Symptoms

The following are signs and symptoms of cutaneous T-cell lymphoma:

• Itchy round patches of skin that may be raised or scaly.

• Skin patches that appears lighter in colour than the surrounding skin

• Lumps that form on the skin and can rupture

• Lymph node enlargement

• Hair thinning

• Skin thickening on the palms of the hands and the soles of the feet

• A rash-like skin redness that is extremely itchy all over the body.

Causes

• It is unknown what causes cutaneous T-cell lymphoma.

• In general, cancer develops when cells' DNA undergoes changes (mutations). The DNA of a cell contains instructions that tell the cell what to do. The DNA mutations instruct the cells to grow and multiply rapidly, resulting in a large number of abnormal cells.

• Mutations in cutaneous T-cell lymphoma cause an overabundance of abnormal T cells that attack the skin. T cells are immune system cells that normally assist your body in fighting germs. Doctors are baffled as to why the cells attack the skin.

Treatment

The different treatments for CTCL include the following:

Treatment for the skin: Treatments that work on the skin to treat CTCL include:

Mechlorethamine gel: It is a type of chemotherapy that is applied to the skin. It has the ability to slow or stop the growth of cancer cells. It has been approved by the Food and Drug Administration (FDA) to treat the most common type of CTCL, mycosis fungoides, in its early stages.

Corticosteroid: This is not used in the treatment of cancer. This medication, when applied to the skin, helps to reduce redness and swelling. It can also help to relieve itch and pain. Because of the possibility of side effects, it is only used to treat small areas of skin.

Retinoid: Retinoids such as bexarotene gel and tazarotene gel are used to treat early CTCL. These medications have the ability to stop or slow the growth of cancer cells.

Radiation therapy: Small doses of radiation can be very effective in removing CTCL from the skin. Radiation can be used to treat specific areas of skin or the entire body.

Light therapy: This treatment kills cancer cells in the skin by exposing them to ultraviolet (UV) rays. PUVA is one type of light therapy. It entails taking a medication known as psoralen before being exposed to UVA light.

Imiquimod: This drug has the potential to be effective in the treatment of early-stage CTCL. It has been shown in studies to remove CTCL from the skin.

Treatment that works throughout the body:

Retinoid: Acitretin, bexarotene and isotretinoin are retinoids that have been used to successfully treat CTCL.

Interferon: Our bodies produce interferon naturally, which stimulates the immune system. Interferon, when used to treat CTCL, stimulates the body's immune system, allowing it to attack cancer cells.

Chemotherapy: It is a treatment that uses medication to kill cancer cells all over the body. Chemotherapy may also harm healthy cells that grow quickly, such as hair cells.

Extracorporeal photopheresis (ECP): This may be a treatment option if cancer cells are found in the blood. ECP entails removing blood with a catheter, treating cancer cells, and then reintroducing the treated blood into your body.

Targeted therapy: These medications aid in the prevention of cancer cell growth and spread. Unlike chemotherapy drugs, which destroy entire cells, this treatment only targets specific parts of cancer cells.

Stem cell transplant: Because this is a newer treatment option for CTCL patients, little is known about it. In one study, researchers followed 47 patients who received a stem cell transplant after other CTCL treatments had failed. After four years, approximately half of the patients who received stem cell transplants were still alive, and 26% still had CTCL but it had not worsened.