The red face: Cutaneous lymphomas

The term cutaneous lymphomas comprises a heterogeneous group of malignancies that preferentially involve the skin. Until the advent of immunohistochemical methods, identification of the cell of origin was based only on cytologic criteria, and considerable confusion has resulted. Most cutaneous lymphomas can now be divided into T- or B-cell proliferations and are usually classified by dermatopathologists based on the presence or absence of epidermotropism and the cell of origin.¹. The most common cutaneous lymphomas are epidermotropic and of T-cell origin. As a rule, they manifest on the face late in the course of the disease, whereas cutaneous B-cell lymphomas (CBCL) and other cutaneous lymphomas present preferentially on the head and neck.² In this article, we focus mainly on epidermotropic cutaneous T-cell lymphomas (CTCLs), which include mycosis fungoides (MF), its leukemic counterpart Sézary syndrome (SS), Woringer-Kolopp disease and acute T-cell leukemia/lymphoma (ATLL), and discuss nonepidermorropic cutaneous T- and B-cell lymphomas only briefly.