A primary care approach to cutaneous T-cell lymphoma

Approximately 1,000 new cases of cutaneous T-cell lymphoma are definitively diagnosed each year. Mycosis fungoides and Sézary syndrome are the primary lymphomas in this group. Mycosis fungoides can begin in the patch, plaque, or tumor stage or in a combination. Less commonly, its initial presentation is erythrodermic. Because the initial appearance of cutaneous T-cell lymphoma can be subtle and the histopathologic evidence nonspecific, the disease is commonly misdiagnosed as a common dermatologic condition such as chronic eczema. Misdiagnosis can severely affect treatment and prognosis. Clinicians must be able to recognize this disease and know when to include it in the differential diagnosis. This article provides an overview of cutaneous T-cell lymphoma, discusses differential diagnoses, and outlines management considerations.