John Libbey Eurotext



Physiopathology, classification and treatment of cutaneous lymphomas Volume 11, issue 5, Octobre 2005

Service de dermatologie, Hôpital Henri-Mondor, AP-HP, INSERM U659, Université Paris 12, Faculté de Médecine, 94010 Créteil

Cutaneous lymphomas are lymphomas beginning and predominating in the skin. They represent the second most frequently occurring site of extranodal lymphomas, after digestive lymphomas. Cutaneous lymphomas are a heterogenous group of entities presenting with various clinical aspects, histology, immuno-histology and evolution. The EORTC classification for cutaneous lymphomas was until now the most used classification in Europe. A consensus WHO-EORTC classification for cutaneous lymphomas has been recently published. T cell lymphomas represent 75 to 80% of cutaneous lymphomas. Mycosis fungoides and its variants, and CD30+ lymphoproliferations are the most frequent types, and have an indolent behaviour, in contrast with rare forms of very aggressive cutaneous T cell lymphomas. Sezary syndrome has an intermediate behaviour. B cell lymphomas represent 20 to 25 % of cutaneous lymphomas. They also have in most cases a favourable prognosis, but it is important to know the intermediate prognosis of leg type large B cell lymphomas. In all cases, a clinicohistologic confrontation and a complete staging must lead to the most appropriate therapeutic choice, avoiding too aggressive treatments in lymphomas with a favourable prognosis.