Other Skin Cancers

Question 1

Includes

Answer 1

Cutaneous lymphomas:

• Mycosis Fungoides
• Sezary Syndrome

Cutaneous metastases

Question 2

What are the types of cutaneous lymphoma? [4]

Answer 2

1. T cell Lymphomas (65%) e.g. mycosis fungoides (MF) or Sezary syndrome
2. B cell lymphomas (20%)

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

Question 3

What does Mycosis Fungoides look like? [3]

Answer 3

Itchy rash - Flat/red/dry/oval (looks like psoriasis/eczema but less homogenous)
They eventually thicken and itch forming plaques.
Large irregular lumps (tumours) form and ulcerate

Question 4

What does Sezary Syndrome look like? [3]

Answer 4

A scaly thickened red itchy rash over the entire body 1 [1] + Lymph node involvement [1]

Question 5

How do we test for cutaneous lymphomas? [3]

Answer 5

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

Question 6

How is cutaneous lymphoma treated? [5]

Answer 6

Topical steroids for the rash
Radiotherapy/Chemotherapy
Methotrexate
Interferon
Phototherapies

Question 7

What phototherapies are used for cutaneous lymphoma [2]

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? [4]

Answer 8

• Primary skin cancers e.g. BCC/SCC/Cutaneous lymphoma
• Breast
• Colon
• Lung

Question 9

How do you investigate and treat cutaneous metastases? [3]

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