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cutaneous T-cell lymphoma (CTCL)

Etiology: - mycosis fungoides/Sezary syndrome Clinical manifestations: - crusted skin lesions developing over a period of 2 months (case report [1] of lesions appearing on nose) - occasional bloody discharge - no pain - no constitutional or other systemic symptoms [1] - ataxia with CNS metastases (case report) [1] Laboratory: - skin biopsy - bone marrow biopsy (no involvement, case report) [1] Radiology: - computed tomography - no lymphadenopathy or metastases (case report) [1] Complications: - CNS metastases may include pons, cerebellum (case report) [1] - lung metastases, pleuro-pulmonary nodules (case report) [1] - cognitive impairment [4] Management: - topical glucocorticoids +/- acitretin, psoralen & UV light & IFN-alfa for early stage disease [2] - chemotherapy* with autologous stem-cell transplantation for metastatic disease (case report) [1] - gentian violet promote apoptosis & inhibit proliferation of cutaneous T-cell lymphoma cells in vitro [3] - suggested as inexpensive, topical therapy [3] * purine analog, histone deacetylase inhibitor, monoclonal Ab

Interactions

disease interactions

Related

cutaneous B-cell lymphoma

Specific

mycosis fungoides/Sezary syndrome

General

peripheral T-cell lymphoid neoplasm skin cancer

References

  1. Aljishi M, Barrow C Cutaneous T-Cell Lymphoma N Engl J Med 2015; 372:2437. June 18, 2015 PMID: 26083208 http://www.nejm.org/doi/full/10.1056/NEJMicm1406401
  2. Medical Knowledge Self Assessment Program (MKSAP) 17, American College of Physicians, Philadelphia 2015
  3. Wu J, Wood GS. Analysis of the Effect of Gentian Violet on Apoptosis and Proliferation in Cutaneous T-Cell Lymphoma in an In Vitro Study. JAMA Dermatol. Published online August 29, 2018. PMID: 30167641 https://jamanetwork.com/journals/jamadermatology/fullarticle/2697566
  4. Garlewicz J Cutaneous T-Cell Lymphoma and Psoriasis Associated With Memory Impairment. The Dermatologist. Aug 8, 2022 https://www.hmpgloballearningnetwork.com/site/thederm/news/cutaneous-t-cell-lymphoma-and-psoriasis-associated-memory-impairment - Damiani G, Tacastacas JD, Wuerz T et al. Cognition/psychological burden and resilience in cutaneous T-cell lymphoma and psoriasis patients: real-life data and implications for the treatment. Biomed Res Int. Published online July 21, 2022 PMID: 35937394 PMCID: PMC9348939 Free PMC article