15
Learning The Basics
1
A
sign
is something a healthcare provider (or the patient) detects on physical
examination (objective). A
symptom
is something a patient notices and states to
their healthcare provider (subjective).
One of the challenges in definitively diagnosing cutaneous lymphoma is
that its signs and symptoms are not the same for all patients. Patches,
plaques, and tumors are clinical names for a variety of skin presentations
(also known as lesions) that can be clues that lead to diagnosis.
Patches are usually flat, possibly scaly, and look like a rash. Plaques are
thicker, raised lesions. Patches and plaques are often mistaken for eczema,
psoriasis, or non-specific dermatitis until a definitive diagnosis is made.
Tumors are raised “bumps” or “nodules” which may or may not ulcerate.
To be called a tumor, generally a nodule has to be at least 1 cm in size,
or greater. A common symptom is itching, although some patients do
not experience this. It is possible to have one or all three of these types of
lesions. Some people have the disease for years and only experience one.
The most common form of cutaneous lymphoma, mycosis fungoides, often
presents with an area of red, slightly scaly skin, usually in sun-protected
parts of the body, with variable size and shape. Common locations for
these symptoms are the buttocks, trunk, upper thighs – all areas that are
typically shielded from sun exposure. Patients with cutaneous lymphoma
find their outbreaks in sun-protected areas of the skin because the natural
UV component of sunlight may have a protective effect against mycosis
fungoides. The exact reason, however, is not known.
Approximately 25% of people diagnosed with mycosis fungoides present
with plaques, which are raised, elevated skin lesions. In the most advanced
stages, symptoms may include round, dome-shaped lumps or bumps that
can break down and ulcerate.
Chapter 3
Signs & Symptoms
