Other Skin Cancers

Question 1

this covers

Answer 1

Cutaneous lymphomas:

• Mycosis Fungoides
• Sezary Syndrome

Cutaneous metastases

Question 2

What are the types of cutaneous lymphoma?

Answer 2

65% are T cell Lymphomas e.g. mycosis fungoides (MF) or Sezary syndrome

20% are B cell lymphomas

They may be 1* cutaneous cancers
Or 2* to systemic/nodal malignancys

Question 3

How does Mycosis Fungoides look?

Answer 3

Rash - Flat/red/dry/oval patches much like psoriasis or eczema
They eventually thicken and itch forming plaques.

Large irregular lumps (tumours) form and ulcerate

Question 4

What does Sezary Syndrome look like?

Answer 4

A scaly thickned red itchy rash over the entire body (think end-stage MF) + Lymph node involvement

Question 5

How do we test for cutaneous lymphomas?

Answer 5

Bloods - Abnormal “Sezary” T cells
CT imaging
Skin/tumour lesion biopsy

Question 6

How is cutaneous lymphoma treated?

Answer 6

Topical steroids for the rash
Radiotherapy/Chemotherapy
Methotrexate
Interferon
Phototherapies

Question 7

What phototherapies are used for cutaneous lymphoma

Answer 7

Total Skin Electron Beam Therapy;
- Irradiating epidermis/dermis while sparing deep tissues

Extracorporeal Photophoresis:

• T cells are filtered out
• Sensitized to UVA using Psoralen
• Exposed to UVA (damaging the diseased cells)
• Re-infused

Question 8

What cancers cause cutaneous metastases?

Answer 8

Primary skin cancers e.g. BCC/SCC/Cutaneous lymphoma

Breast
Colon
Lung

Question 9

How do you investigate and treat cutaneous metastases?

Answer 9

Do a biopsy which will show where the tumour came from

then excision and radiotherapy

If its too advanced there are palliative and symptomatic treatments