CTCL is the acronym for cutaneous T-cell lymphoma, a general term for several types of lymphomas of the skin that derive from T-cells, including mycosis fungoides, Sézary syndrome, primary cutaneous anaplastic large cell lymphoma, lymphomatoid papulosis, granulomatous slack skin disease, pagetoid reticulosis, and subcutaneous panniculitis-like T-cell lymphoma, to name a few. Most CTCLs typically fall into the category of indolent (i.e. chronic) lymphomas – treatable, but not curable and usually not life-threatening.
In CTCL, malignant T-cells travel to the upper layers of the skin, causing a rash, which leads to diagnosis.
CTCL is sometimes wrongly referred to as a skin cancer because it affects the skin, but this is not a precise use of the term “skin cancer.” Skin cancer is the designation for cancers that develop from other, non-lymphoid cells of the skin, including epidermal cells (which lead to squamous cell carcinoma) and melanocytes or pigment cells (which lead to melanoma).
As a group, CTCL is a relatively rare family of diseases with approximately 3,000 new cases reported in the United States every year. More common among men than women, CTCL occurs more in patients older than 50 years of age than in younger people. It is important to know, too, that CTCL is not contagious. It is not an infection and cannot be passed from person to person.
The two most common types of CTCL are mycosis fungoides (MF) and Sézary syndrome (SS). Together, they make up about three quarters of all CTCL.
Treatments vary from patient to patient, depending on symptoms, stage of disease and personal health profile. Treatments are either directed at the skin (skin-directed therapies) or the entire body (systemic therapies). It is important that patients discuss fully with their physician all the treatment options before deciding on a course of action.
Skin-directed therapies include ultraviolet light (PUVA, UVB, narrow-band UVB), topical steroids, topical chemotherapy (nitrogen mustard, carmustine), topical retinoids, local radiation to single lesions or total skin electron beam (TSEB) radiation. Full-body, or systemic, therapies include oral retinoids, photopheresis, interferon, and systemic chemotherapy. All treatments may be prescribed alone or in combination, with the goal of achieving the best, long-term benefits for the patient.