Cutaneous T-Cell Lymphoma

Mycosis Fungoides-type Cutaneous T-cell Lymphoma (MF-CTCL) is a rare cancer that progresses slowly and unpredictably. It occurs when a type of white blood cell (T-cell), which is part of the immune system that normally fights infection, starts to multiply abnormally in the skin. This type of cancer is called a lymphoma. Mycosis fungoides (MF) is the most common form CTCL. It is estimated that, since patients have a very long survival, there may be as many as 19,000 patients living with cutaneous lymphoma in Europe.  MF-CTCL is more common in men than women, in black and brown skin than white, and in people older than 50 years of age than younger people.  
 
MF-CTCL can look like other common skin conditions and might be present for years or even decades before it’s diagnosed as MF-CTCL.   Patches, plaques and tumours are the clinical names for different skin manifestations and are generally defined as 'lesions'.  While it is possible to have all three types of lesions at the same time, most people who have had the disease for many years’ experience only one or two types of lesions - generally patches and plaques. Itching is a common symptom of MF-CTCL affecting at least 80 % of people. MF-CTCL is not a contagious infection and cannot be passed from person to person.
 
MF-CTCL is very difficult to diagnose, especially in its early stages. The symptoms and skin biopsy findings of MF-CTCL are similar to other benign skin conditions like eczema, psoriasis, parapsoriasis and pityriasis lichenoides. MF-CTCL is sometimes diagnosed initially only by dermatologists or oncologists who specialise in cutaneous lymphomas. 
 
The treatments for MF-CTCL are continuously evolving.  At any one time, there are numerous clinical trials ongoing to determine better treatments.  In most patients with MF-CTCL, the lymphoma cells are primarily limited to the skin, and can bring excellent and long-lasting responses with treatments directed at the skin ('skin directed therapy').   Examples of skin directed therapies are creams, ointments, and gels that are applied to the skin, such as topical steroids, topical nitrogen mustard, retinoids, chlormethine and immune stimulating creams (imiquimod).  Ultraviolet light ('medical tanning') and radiation therapy are also types of skin directed therapy.  'Systemic therapy' refers any treatment that, after absorption, reaches the bloodstream and is therefore distributed across the body 'system'. 
 
Systemic therapies are used in MF-CTCL when skin directed therapies aren’t working well enough.