Some types of lymphoma can affect the skin, which may look like a rash. A rash is defined as "An area of the skin that has changes in texture or color and may look inflamed or irritated. The skin may be red, warm, scaly, bumpy, dry, itchy, swollen, or painful. It may also crack or blister. A rash can occur in one area of the body or all over the body and may look very different depending on the cause." -National Cancer Institute.
A lymphoma rash is a skin change caused by lymphoma in the skin (cutaneous lymphoma), reactions to lymphoma elsewhere in the body, or a rash caused by lymphoma treatment. Learn what these changes can look like and when to tell your care team.
What is cutaneous lymphoma?
Cutaneous lymphoma is a lymphoma that starts in the skin. Most types are forms of non-Hodgkin lymphoma.
These lymphomas start in T cells or B cells. Both are white blood cells that help your immune system work. About 75% of primary cutaneous lymphomas are T-cell lymphomas in Western countries. About 25% are B-cell lymphomas.
A rash alone cannot tell you if you have cutaneous lymphoma. Doctors often need a skin biopsy to make a diagnosis. During a biopsy, a small piece of skin is removed and tested.
What does cutaneous T-cell lymphoma look like?
Cutaneous T-cell lymphoma (CTCL) is a group of lymphomas that start in T cells in the skin. The most common type is mycosis fungoides.
Mycosis fungoides often starts as flat patches. It can also cause plaques, which are thick, raised areas of skin. The skin may look red, dry, or scaly. It may also itch. These changes often appear on areas that get less sun.
Mycosis fungoides can look like eczema or psoriasis. This can make it hard to diagnose. To see what this rash looks like, click here.
Sézary syndrome is another type of CTCL. It involves lymphoma cells in the blood. It can cause widespread red, scaly, and itchy skin. To see what this rash looks like, click here.
Other types include lymphomatoid papulosis and primary cutaneous anaplastic large cell lymphoma. These can cause raised bumps or larger nodules on the skin.
What do cutaneous B-cell lymphomas look like?
Primary cutaneous B-cell lymphoma (PCBCL) starts in B cells in the skin. It may cause pink, red, or purple patches or raised areas. To see what this rash looks like, click here.
The location can depend on the type:
Primary cutaneous follicle center lymphoma often affects the scalp, forehead, or torso.
Primary cutaneous marginal zone lymphoma often affects the arms or torso.
Primary cutaneous diffuse large B-cell lymphoma, leg type, often causes fast-growing red or purple lumps on one or both legs.
These types can act differently and may need different care. Testing a skin sample helps doctors find the exact type.
Can Hodgkin lymphoma affect the skin?
Hodgkin lymphoma can affect the skin, but this is rare. It usually starts somewhere else in the body before reaching the skin.
Skin changes may include red bumps or larger nodules. Some may break open and form sores. These changes have been reported on the scalp, neck, chest, armpits, arms, and legs.
Very rarely, Hodgkin lymphoma may seem to start in the skin. This is called primary cutaneous Hodgkin lymphoma. Doctors must check for lymphoma in other parts of the body before making this diagnosis. To see what this rash looks like, click here.
Hodgkin lymphoma can also cause itching without lymphoma cells in the skin. Itching alone does not mean lymphoma has spread to the skin.
Does a lymphoma rash come and go?
It can, depending on the type. With mycosis fungoides and Sézary syndrome, skin symptoms may get better or worse over time.
This pattern does not mean a rash is lymphoma. Many other skin problems can change over time. Tell your care team if a rash keeps coming back or does not go away.
Rashes caused by lymphoma treatments
Some lymphoma treatments can cause rashes that may be red, raised, itchy, or widespread. Therapies like lenalidomide, rituximab, and bendamustine have been linked to treatment-related rashes. Most are mild to moderate and can often be managed with antihistamines or corticosteroids.
Tell your care team about any new rash during treatment. Some rashes may require treatment changes, especially if they become severe, spread quickly, blister, or cause skin peeling.
When to tell your care team about a rash
There is no single type of lymphoma rash. Its look and location can vary based on the type of lymphoma. Most rashes are not caused by lymphoma, but tell your care team about skin changes that last, return, grow, or change.
Your care team may examine your skin and order tests. A skin biopsy may be needed to find the cause and determine if treatment is needed.
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