A Patient’s Guide to Understanding
Cutaneous Lymphoma
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next steps in care and treatment. With a number of different types and
subtypes, building a case for diagnosis based on multiple elements is vital.
Assessment of a patient’s symptoms, coupled with a history of skin lesions
and consistent biopsies, are critical components that help build a patient’s
individual case and accelerate the diagnostic process.
In some cases, test results, including skin biopsies, are not conclusive.
When this happens, patients should discuss options with their healthcare
provider. Some may receive the recommendation to seek relief from
symptoms by starting a non-systemic treatment such as a topical lotion,
steroid cream or ointment, or even ultraviolet light therapy. Others may
prefer to wait for a recommendation to take additional biopsies of the skin
lesion to aim for more conclusive results.
Importance of the Skin Biopsy
A biopsy is a simple outpatient procedure that involves removing a small
sample of tissue from the skin for examination. When a biopsy is performed,
local anesthetic is given prior to the procedure. Following the procedure,
the skin is sewn together with a couple of stitches, leaving a very small,
almost invisible scar.
Given the complexity of cutaneous lymphomas, it is important to have the
diagnosis confirmed by a dermatopathologist or a hematopathologist –
these pathologists are experts in diagnosing lymphomas. The pathologist
analyzes biological tissue and reviews all test results. Typically, the presence
of an excess of certain kinds of T-lymphocyte cells, arranged in certain
patterns within the tissue, indicates a skin lymphoma. A definitive diagnosis
cannot be obtained without a biopsy, and multiple biopsies are necessary to
confirm the presence of excess T-lymphocyte cells and consistent patterns.
The physician and pathologist will need to work together to determine a
proper diagnosis.
To conduct an effective, informative biopsy, patients need to be off topical
steroids and ultraviolet light treatment regimens for at least a week or two.
While these treatments may provide temporary symptom relief, they can
also mask potential symptoms of skin lymphomas and thus delay a patient’s
definitive diagnosis. Consistent biopsies over time are an integral step in
obtaining a proper diagnosis.
