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Cutaneous T-cell lymphoma (CTCL) is a type of non-Hodgkin's lymphoma, which is a cancer of the immune system. Unlike most non-Hodgkin's lymphomas, which are generally B-cell lymphomas, CTCL is caused by an abnormality in T-cells, a type of white blood cell. These cancerous T-cells migrate to the skin, causing various lesions to appear. These can be very itchy and may appear as patches, plaques, or tumors. CTCL is typically a slow-growing cancer that can develop over many years. However, it can be progressive and become more serious over time.

Types of Cutaneous T-Cell Lymphoma

There are several types of CTCL, each with its own unique set of symptoms and prognosis. The most common types include:

  • Mycosis fungoides: This is the most common form of CTCL. It often appears as red, scaly patches or thickened plaques of skin that resemble eczema or chronic dermatitis.
  • Sézary syndrome: This is a more aggressive form of CTCL that affects the skin throughout the body. It also affects the blood and lymph nodes and can cause severe itching and redness of the skin.
  • Primary cutaneous anaplastic large cell lymphoma: This type of CTCL is less common and tends to be more aggressive. It often appears as tumors or ulcers on the skin.
  • Lymphomatoid papulosis: This is a milder form of CTCL that often appears as a rash of red bumps on the skin.

Why Do People Get Cutaneous T-Cell Lymphoma?

The exact cause of CTCL is not known. However, it is believed to be caused by changes or mutations in the DNA of T-cells that cause the cells to grow and divide uncontrollably. Some factors that may increase the risk of developing CTCL include:

  • Age: CTCL is more common in older adults, typically appearing in people over the age of 50.
  • Gender: Men are slightly more likely to develop CTCL than women.
  • Race: CTCL is more common in African Americans than in Whites.
  • Family history: Having a family member with CTCL may increase a person's risk of developing the disease, suggesting a possible genetic component.

However, it's important to note that having one or more of these risk factors does not mean a person will definitely develop CTCL. Most people with these risk factors do not develop the disease.

Who Gets Cutaneous T-Cell Lymphoma?

The overall incidence of CTCL is unknown but one recent study found that there were 8.55 people per million diagnosed with CTCL from 2000 to 2018. In this study, mycosis fungoides was the most common diagnosis, followed by primary CTCL and then primary cutaneous anaplastic large cell lymphoma. Mycosis fungoides and Sézary syndrome are more often diagnosed in men than in women and usually are first diagnosed in people between the ages of 50 to 60 years old. The median age of diagnosis has ranged in various studies from 52-62 years old and all studies find a male predominance compared to females. 

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