Pruritus in Cutaneous T-Cell Lymphomas

Excerpt

Cutaneous T-cell lymphomas (CTCL) are a group of lymphoproliferative disorders characterized by a clonal accumulation of neoplastic memory T-lymphocytes in the skin (Girardi et al. 2004; Meyer et al. 2010). CTCL are the most common primary cutaneous lymphomas. Their incidence has increased from 5 cases per 1,000,000 in the 1980s to 12.7 per 1,000,000 in the 2000s (Bradford et al. 2009). Mycosis fungoides (MF) is the most common variant of CTCL. Typically, patients initially present with erythematous patches in sun-protected areas, which may progress to plaques and possibly skin tumors. Sézary syndrome (SS) is a more aggressive form of CTCL, characterized by the association of an exfoliative erythroderma with the presence of atypical mononuclear cells in the skin and in the peripheral blood (Sezary cells). Patients with early stage CTCL have a good prognosis, whereas the prognosis is poorer for patients with late-stage disease (Klemke et al. 2005; Willemze et al. 2005). CTCL can cause significant morbidity and adversely affect patients’ quality of life (Demierre et al. 2003, 2005, 2006), in part owing to the fact that CTCL are highly associated with pruritus (Demierre and Taverna 2006). CTCL have multiple subtypes (Willemze et al. 2005).