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Patients with T-cell lymphomas generally have flat rashes called patches or plaques. The rash may start in a small area and then extend over large areas of the body. The patches may be red, itchy and dry, and cracks may form in the skin.
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Read More »A team approach is used to treat skin lymphomas. Dermatologists, medical oncologists, radiation oncologists and surgeons may all be involved in treating a patient. Treatment options depend on how advanced the cancer is and such factors as the patient’s overall health and responsiveness to different treatment methods. The methods we use to treat skin lymphoma include: Radiation therapy: Radiation therapy is a common treatment for skin lymphoma. It consists of a machine aiming radiation beams at specific parts of the body. The radiation disrupts the functioning of cancer cells so that they cannot reproduce. Those therapies are administered by a radiation oncologist who specializes in treating cancer with radiation. Each treatment session lasts about 20 minutes and is performed four to five days a week for three to nine weeks, depending on the clinical situation. At Yale Medicine, we use two kinds of radiation treatment to treat skin lymphomas: Total skin electron beam therapy (TSEB) or ;ocalized radiation With total skin electron beam therapy, the entire surface of the skin receives radiation. The radiation is delivered as the patient stands on a platform in different positions so that the entire surface area of the skin is “hit” with radiation. The electron beam doesn’t penetrate deep into the body, so effectively only the skin is treated and internal organs are not affected. TSEB is “very complicated technically,” Dr. Wilson says. “It’s advantageous for patients that this be done in a center with experience.” Yale Medicine is one of very few medical centers that has vast experience treating people with TSEB. Patients from across the United States and abroad travel to Yale Medicine to take advantage of our doctors’ expertise. As opposed to the entire skin area, localized radiation targets a small section of skin, including just single lesions. There are several possible side effects of radiation therapy. Whether or not you experience just a few or several of them depends on the treatment dose used, the extent of the radiation fields and your response. Most of the side effects are related to the skin. The skin may become red or swollen, or blisters may form. In addition, the fingernails and toenails may become weak or break easily. Other possible side effects include hair loss, cataracts and fatigue. Most patients recover from those side effects within several weeks after treatment, although hair can take longer to grow back.
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Read More »Topical treatment: Topical treatments are prescribed by a dermatologist and are applied to the skin. This includes such medicines as steroid creams, which are put directly on the lesions. Topical treatment is most effective in early skin lymphomas where the lesions cover a small area and the cancer has not spread to other organs. UV light therapy: Dermatologists also may use ultraviolet light therapy, in which UV radiation is aimed at the skin using special lamps. (UV radiation is a less intense form of radiation than that used in radiation therapy.) The UV light kills cancer cells in the skin; this therapy is most effective on thinner skin lesions. Systemic treatment: If the lymphoma has spread beyond the skin, treatments are likely to focus on the whole body. Systemic treatments consist of medicines that enter the bloodstream and are then delivered throughout the entire body. Dermatologists or medical oncologists, for example, may prescribe a pill with similar medicinal qualities as a topical cream and may prescribe injections. Another systemic treatment dermatologists perform is photopheresis, a blood treatment in which blood is drawn from the patient and treated with ultraviolet light and then reinfused back into the patient. Medical oncologists also provide systemic treatments, ranging from oral drugs to chemotherapy, in which powerful drugs are administered that kill cancer cells throughout the body. Surgery: Surgery to treat skin lymphomas is largely reserved for early-stage B-cell lymphomas that are isolated and only in one location. “If you have a little pimple-type lesion,” Dr. Wilson says, “or something that's only a centimeter-wide on your skin, then that can typically be surgically excised with very good results.” Surgery is typically not used for T-cell lymphomas because those types are usually spread over at least several centimeters of skin, and thus would require extensive surgery. In those cases radiation is preferred.
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