Lymphoma is a type of cancer that starts in immune cells called lymphocytes. Lymphoma can cause a rash that appears as one or more scaly patches, plaques, or nodules.
A lymphoma rash, such as mycosis fungoides (MF), can be easy to confuse with other skin conditions, such as psoriasis or eczema, which can cause similar symptoms. A person may also experience other symptoms, and these can help doctors make the correct diagnosis.
Early diagnosis and treatment are vital, and the combination of approaches will depend on the type of lymphoma a person has. In this article, learn more about lymphoma rashes.
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A lymphoma rash is not a term that doctors usually use, but some people use the term to describe skin-related symptoms of lymphoma.
Skin rashes are uncommon symptoms of Hodgkin lymphoma, but they may result more often from other types of lymphoma that start in T or B cells.
Of all skin lymphomas are MF. The most common type of cutaneous T cell lymphoma, MF occurs when cancerous T cells are present in the skin with a characteristic presentation of patches, plaques, and sometimes tumor-like lesions.
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The most common sign of MF is a rash consisting of one or more scaly, inflamed patches of skin. These patches are generally itchy, and they are easiest to recognize in a bathing suit distribution, commonly appearing on the buttocks and thighs.
Over time, the rash may become more severe and spread to other areas. The affected skin may get thick and hard, and form raised plaques. The plaques may darken and possibly bleed. Some form tumor-like raised lesions.
Other people with MF may experience a very dry and itchy redness over a majority of their skin, and this can indicate Sezary syndrome.
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Doctors consider Sezary syndrome to be relatively distinct from typical MF. In Sezary syndrome, the cancerous T cell is a different type from that of MF.
While MF is the most common type of cutaneous T cell lymphoma, there are many other types, some of which are very rare.
The rash and plaques may get worse as the condition progresses. In some individuals, tumor-like lesions develop on the skin. The cancer may spread to the lymph nodes or other areas of the body.
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These symptoms can result from many types of lymphoma, including those that originate in areas other than the skin, known as systemic lymphomas.
No standard diagnostic criteria for MF exist, and a diagnosis largely relies on the findings of a skin biopsy. To make matters more difficult, eczema and similar conditions can look like MF on a biopsy. For this reason, the doctor will usually take multiple biopsies.
Diagnosing a lymphoma rash, such as MF, can take time. The symptoms of lymphoma can be easy to miss at first, so seeing a doctor early on is vital.
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The doctor will likely also check for signs of enlarged lymph nodes, and if these are present, they may request a biopsy of an enlarged node.
In addition, imaging tests can help doctors determine whether skin lymphoma has spread to other areas of the body. A doctor may use any of the following:
For skin lymphomas, such as MF, doctors may recommend prescription topical creams or ointments that contain corticosteroids, chemotherapy drugs, or retinoids. These may help control pain and itchiness or clear the rash and help slow the progress of the cancer.
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Most people with MF may also benefit from phototherapy, which uses ultraviolet light. Narrow-band ultraviolet B treatment is a very common phototherapy for MF.
In some cases, the doctor may prescribe a particular medication that aids treatment with ultraviolet A rays. The medical term for this combination is psoralen and ultraviolet A, or PUVA, therapy.
Combination therapies can be very effective in some cases. Authors of 2016 research found that 81% of people included in the study who had MF and a combination of drug and UV light therapy responded to treatment.
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Surgery is not a common treatment for cutaneous T cell lymphoma unless a person has only an isolated plaque, which can occur with certain types of this lymphoma.
The outlook for a person with cutaneous T cell lymphoma depends on the type of the disease and how far it has advanced by the time that they receive a diagnosis.
Many people with MF are able to manage symptoms and keep the cancer from progressing for long periods. In others, the disease progresses quickly and moves to other areas of the body.
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Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Did you know that lymphoma is an umbrella term that includes several subtypes? In general, lymphoma is a cancer that involves immune cells, either T cells or B cells.
These cells travel throughout your body to help protect you from infection and illness. That includes traveling to the skin to help heal a cut or clear an infection.
Although skin lymphoma can originate from B cells, it’s more often seen with T cells. This is known as cutaneous T cell lymphoma. There are two main subtypes of cutaneous T cell lymphoma:
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It’s sort of in between. Because it involves T cells that are produced in the bone marrow, cutaneous T cell lymphoma is technically a blood cancer. But most cases only involve the skin and can be treated like a skin condition.
For example, at MD Anderson, patients with a cutaneous T cell lymphoma are often first referred to the Cutaneous T Cell Lymphoma Clinic, which is part of our Melanoma and Skin Clinic. Our patients are cared for by a team of dermatologists who specialize in the disease. However, we work closely with our colleagues in the Lymphoma and Myeloma Center to manage all aspects of the disease.
There are several ways cutaneous T cell lymphoma can appear. In its early stages, it can look like flaky, dry skin, so it’s often mistaken for eczema. It can also appear scaly like psoriasis and even as blisters on the skin.
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Those plaques sometimes continue to develop into lumpy areas of the skin or into ulcers. That’s what we call tumors for this disease.
Some patients have a red, flaky rash that covers their entire bodies. It can look almost like a third-degree sunburn. This is known as erythroderma and is more commonly seen in patients with Sézary syndrome.
Because cutaneous T cell lymphoma can look like several other skin issues, it can be a challenging disease to diagnose. There have also been situations where people feel itchy or burning but aren’t showing any redness. Or, for patients with a darker skin tone, it’s more challenging to see the redness.
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If there isn’t an explanation for the discomfort, or if a rash isn’t responding to typical treatment, a skin biopsy is the first step to learning more.
Cancer centers like MD Anderson have pathologists who specialize in cutaneous lymphoma. We also have resources such as additional pathology stains and next-generation sequencing molecular testing that reveal even more specifics about a diagnosis and help us refine treatment.
Approximately 80% of patients will have the disease remain in their skin. It’s not uncommon for people to go years without realizing they have cutaneous T cell lymphoma. Instead, they’ll assume they’ve had eczema or psoriasis. Our first treatment approach is typically a mid- or high-potency steroid. Sometimes that’s all that is needed, but if that doesn’t clear it, we have chemotherapy and immunotherapy that are applied as creams.
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If the skin lymphoma continues to spread to more than 10% of a patient’s body, it becomes more challenging to use a cream as treatment since it has to be applied to a larger area. That’s when we turn to ultraviolet therapy or photodynamic therapy.
If a patient develops plaques or tumors, or if the disease turns internal and starts to spread to the lymph nodes, this is known as advanced disease.
We co-manage treatment with our colleagues in radiation therapy. They specialize in treating lymphoma of the skin, so they’re able to give patients the lowest possible radiation dosage that’s still effective.
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Additionally, patients with advanced disease may be treated with oral retinoids, monoclonal antibodies and/or chemotherapy. Patients at MD Anderson also have access to a large number of clinical trials for this disease.
Although cutaneous T cell lymphoma can seem like a milder cancer diagnosis, it’s important to see an expert who specializes in this disease. Going to someone unfamiliar with this disease could delay accurate diagnosis and optimal treatment.
Not every patient needs to receive systemic chemotherapy and endure those side effects. It’s also possible to receive too high a dose of radiation therapy, which then prevents you from being eligible for the therapy in the future. At a specialized center like MD Anderson that takes a multidisciplinary approach, you will have a multidisciplinary team of dermatologists, radiation oncologists and medical oncologists working together to
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