ABSTRACT
Cutaneous lymphomas are a diverse group of lymphoproliferative disorders with a wide range of clinical presentations, histologic findings, and prognoses. Unlike their systemic counterparts, cutaneous lymphomas originate in the skin and have a different prognosis and treatment approach. Primary cutaneous lymphomas are subdivided into cutaneous T-cell lymphoma (CTCL), cutaneous B-cell lymphoma (CBCL), and other lymphomas arising from natural killer cells. Management of CTCL varies depending on the stage and type of CTCL. Therapies can be divided into skin-directed therapies, such as narrowband ultraviolent-B phototherapy, radiation therapy, and topical agents. Advanced disease can be managed with a variety of systemic therapies, including brentuximab vedotin, romidepsin, and liposomal doxorubicin. CBCL generally portend a favorable prognosis. Local disease can be managed with surgery and radiation. More extensive disease requires rituximab. The subtype diffuse large B-cell lymphoma is typically associated with poor prognosis and requires aggressive treatment with systemic chemotherapy and rituximab, which can be toxic to elderly patients. The following cases demonstrate the approach to managing various subtypes of cutaneous lymphoma.
