Lymphoma-associated skin cancer: incidence, natural history, and clinical management

The link between immunosuppression and skin cancer has been well described. The two most common situations involving immunosuppression-associated skin cancer are solid organ transplantation and non-Hodgkin lymphoma (NHL), including chronic lymphocytic leukemia (CLL). Patients with lymphoma are more likely to have development of a secondary malignancy, with skin cancer being the most common. The most common types of skin cancer in patients with NHL/CLL include melanoma, squamous cell carcinoma, basal cell carcinoma, and Merkel cell carcinoma. Many skin cancers demonstrate increased aggressiveness in patients with NHL/CLL and are associated with higher recurrence rates, increased regional metastasis, and death secondary to skin cancer metastases. This review delineates the current research regarding the relationship between NHL/CLL and cutaneous malignancy. Immunosuppressed patients with skin cancer should be treated promptly and aggressively to decrease recurrence and metastases. Regular skin self-examinations, dermatologic examinations, sun-protective habits, and education may prove beneficial in this high-risk patient population.