cutaneous lymphoma | Skin lymphoma

Skin lymphoma

The board
Alongside the most common skin cancers, carcinomas or melanomas, there are rarer cancers developed at
From the lymphocytes, immune cells normally present in the skin. These are cutaneous lymphomas
There are several types. They must be differentiated from the lymphomas developed from the lymph nodes, as their evolution and
Treatment are different.

The stages of diagnosis
Suspicion of cancer
The most common cutaneous lymphoma is called the Mycosis
Fungoides. It is developed from T-cells that
Multiply in the superficial layers of the skin. It
Occurs more often in adults around 50 years and is
Manifested by red plates that itch and are
Located at the beginning on the hidden areas of light
Buttocks, the internal faces of the arms or thighs). At the beginning
The plates can disappear on their own or with the exposure
In the sun, but then they persist and can
Spread. The evolution of this lymphoma is generally slow
Over several decades. At the plate stage, it does not
Don't put the vital prognosis into play.
Other rarer cutaneous lymphomas exist that can
Prove to be in the form of pinkish to purplish nodules,
Sometimes in the form of a redness of the whole
Of the body so-called a toxic.
Diagnostic Confirmation: Determine
The type of lymphoma
The first test to be performed is a skin biopsy that
is to remove a fragment of the skin
Local anesthesia. This action can be done by the dermatologist
In town. The biopsy is sent to the laboratory
Analyzes the type of lymphocytes that proliferate and accurately
So the type of lymphoma. This is an essential step because
It conditions the management. Sometimes the biopsy requires
More detailed analysis. It is then sent to
A reference laboratory member of the INCA Lymphopath network
Including that of the CHU of Bordeaux is part. It may
Need to redo the biopsy to collect and send it
In the laboratory under special conditions. This
is done at the hospital with a referral dermatologist for
Cutaneous lymphomas. The diagnosis is then validated at the
A multi-disciplinary consultation meeting (RCP)
Specialized for cutaneous lymphomas

Skin lymphoma

Determine the stage of lymphoma
Once the type of lymphoma is established, you need to:
-Evaluate the skin stage according to the type, extent or
Number of lesions
-Check the absence of damage outside the skin. This balance sheet
Must be negative to confirm that it is a lymphoma
Primitively developed from the skin. The
Balance sheet is adapted to the type of lymphoma and the extension of
Lesions. Thus for a mycosis fungoides with very little
Only the clinical examination verifying the absence of lymph nodes
And a blood sample is needed. In other
case, we carry out a scanner of the thorax, the abdomen
and the pelvis. In rare cases an examination of the marrow
(bone marrow biopsy) is performed.

Possible treatments
Many treatments are possible and recommendations
Adapted to the type and stage of lymphoma
Skin. In the Mycosis fungoides with lesions
In plaques, we use primarily treatment
Home-made premises ranging from corticosteroids to cream
Local chemotherapy applications. In forms
Resistant or more advanced, immunotherapy treatments,
Biological treatment, radiotherapy and more
Rarely chemotherapy are discussed. This choice is made at the
Course of PCR Regional monthly cutaneous lymphomas
From the CHU of Bordeaux. You should know that for the mycosis
Fungoides A maintenance treatment is often necessary.
For other types of lymphoma treatments are
Very variable. There are many lymphomas of very
Good prognosis in the form of nodules or
Unique tumor that are treated by localized radiotherapy
Only.

At the CHU of Bordeaux
The CHU of Bordeaux has specific equipments,
such as Unbody photochemotherapy or electron therapy
Superficial, which is aimed at forms of
Extents of Mycosis fungoides.
The high-Lévêque dermatology service is centre
Expert in the INCa Network for cutaneous lymphomas. It
Organizes regional RCP, participates in the national RCP
Use of the French group for the study of cutaneous lymphomas,
can offer patients therapeutic trials
Which allow access to innovative molecules not
Still available on the market and has also put in
Place a cohort of cutaneous lymphomas in Aquitaine
To clarify their frequency and conduct an investigation
Environmental factors that may be associated.

Followed
The follow-up of cutaneous lymphomas is mainly clinical.
For the mycosis fungoides in plates, an alternate follow-up between
The city dermatologist and the hospital dermatologist
The referral is often put in place, knowing that the treatment
Often has to be extended. It can sometimes be
But recurrences are frequent and require
Resume treatment several months or even keep
Continuous Maintenance treatment
For lymphomas in the form of nodules treated with
Radiotherapy, the follow-up is carried out mainly by the dermatologist
Of the city, knowing that in the majority of cases
The cure is obtained with this treatment.
For more advanced or more aggressive lymphomas, monitoring
is performed exclusively at the hospital because it is often necessary to
To adapt the treatment.