II. Epidemiology

  1. Cutaneous B-cell Lymphoma (CBCL) Incidence: 4 per Million persons

III. Pathophysiology

IV. Types: Primary Cutaneous Lymphoma

  1. Cutaneous B-cell Lymphoma (CBCL, 25% of cases)
    1. Primary Marginal Zone Lymphoma (PCMZL, 25-30% of CBCL)
      1. Males (60%) aged 20 to 60 years old
      2. Red Papules, Plaques or Nodules (often solitary) on trunk and extremities
      3. Treated with low dose Radiation Therapy, excision , intralesional steroids or observation
        1. Multiple sites are treated with low dose Radiation Therapy or Rituximab
      4. Indolent Lymphoma with 99% five year survival (50% relapse rate)
    2. Primary Cutaneous Follicle Center Lymphoma (PCFCL, 30-60% of CBCL)
      1. Males (60%) aged 40 to 70 years old
      2. Red Papules, Plaques or Nodules (often solitary, may be clustered) on head, neck, trunk
      3. Treated with low dose Radiation Therapy, excision , intralesional steroids or observation
        1. Multiple sites are treated with low dose Radiation Therapy or Rituximab
      4. Indolent Lymphoma with 95% five year survival (30% relapse rate)
    3. Primary Cutaneous Diffuse Large B-Cell Lymphoma (PCDLBCL, 20-40% of CBCL)
      1. Females (66%) age >60 years
      2. Red to blue Nodules (often solitary) on the lower leg
      3. Treated with systemic Chemotherapy and possible Radiation Therapy
      4. Aggressive Lymphoma with 30-80% five year mortality with R-CHOP (65% relapse rate)
    4. EBV-Positive Mucocutaneous Ulcer (EBVMCU, rare)
      1. Age >60 years, associated with Immunosuppression
      2. Well circumscribed, painful Mucosal Ulcers
      3. Indolent Lymphoma
  2. Primary Cutaneous T-Cell Lymphoma (CTCL, 75% of cases)
    1. See Cutaneous T-Cell Lymphoma
    2. This topic focuses instead on Cutaneous B-cell Lymphoma

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