Psoriasis been found to be potentially associated with heightened risk of two types of lymphoma, Hodgkin's lymphoma (HL) and cutaneous T-cell lymphoma (CTCL). The link is not yet understood or even confirmed. The association may be because people with abnormal immune systems may develop psoriasis, and this same abnormality predisposes them to lymphoma as well. Another theory is that some of the drugs used to treat psoriasis, if taken systemically, may induce lymphoma in someone who is already genetically predisposed. Because the link between the two diseases is still unclear, it is important to educate yourself about suspicious signs and symptoms, see a doctor for evaluation and diagnostic tests if needed, and receive treatment promptly if you are diagnosed with lymphoma.
Method One of Three:
Noticing Symptoms of a Possible LymphomaEdit
1Recognize signs and symptoms that may be suspicious of Hodgkin's lymphoma (HL). HL is a cancer of a certain type of immune cell or white blood cell that resides in the lymph nodes (hence the term lymp-oma, meaning lymph node cancer). HL typically presents as one or more enlarged lymph nodes. These may occur anywhere in the body, such as in the neck, above the collarbone, in the armpit, or in the groin.
- Enlarged lymph nodes may also occur for other reasons, such as an infection, so it does not necessarily mean that there is cancer present.
- However, if the enlarged lymph node persists, or you notice it continuing to grow, especially if it is hard, fixed, and immobile, seek professional medical evaluation immediately.
2Watch for reddish bumps on the skin. It is key to look out for for signs and symptoms that may be suspicious of cutaneous T-cell lymphoma (CTCL) – MF type. The MF (Mycosis fungoides) subtype of CTCL typically presents as reddish bumps on the skin. These may have a variety of appearances, from flat, to patch-like, to scaly (resembling psoriasis), to nodular.
3Observe for a large red lesion on your skin. It is also important to watch for signs and symptoms that may be worrisome for cutaneous T-cell lymphoma (CTCL) – Sezary type. The Sezary type of CTCL is the more severe version (a step up from the Mycosis fungoides type). It is also known as the "red man syndrome," because the entire skin becomes like one great big red lesion. It is very severe and warrants immediate medical attention.
4Take note of any generalized cancer symptoms. Things to look for include unexpected weight loss (of 10% or more over the past six months), drenching night sweats (requiring you to change your bed sheets), and/or an unexplained fever of over 38 degrees Celsius (100.4 degrees Fahrenheit). If you are experiencing any of the above (called "B-symptoms"), they are "red flag" symptoms for a possible cancer and warrant immediate medical attention.Advertisement
Method Two of Three:
Seeing a PhysicianEdit
1See your physician if you have any reason to suspect a possible lymphoma. If you notice a suspicious lymph node, a concerning lesion on your skin, or generalized "red flags" signs of possible cancer, you will want to book an immediate appointment with your doctor. You may even be sent to see a skin specialist (a dermatologist) to more carefully examine the area of concern and to perform diagnostic tests as needed.
- To diagnose CTCL, a skin biopsy will suffice. A skin biopsy can differentiate between psoriasis lesions and lesions that are a possible cutaneous lymphoma (CTCL).
- A lymph node biopsy will be needed to rule in or rule out the presence of cancer (Hodgkin's lymphoma) in a suspicious lymph node.
- Note that you may need to receive multiple evaluations (skin biopsies, and/or lymph node biopsies) if the initial biopsies are inconclusive.
- Sometimes the diagnosis of cancer (lymphoma) becomes more obvious on biopsies over time, so follow your physician's recommendations and receive appropriate follow-up tests as needed.
2Proceed with your regular psoriasis medications. It is key to note that there is no current evidence to alter your psoriasis medications as a means to reduce your risk of developing lymphoma. The heightened risk of lymphoma is thought to be more likely related to the underlying disease process of psoriasis, rather than to the medical treatments.
- It is possible that some of the immunosuppressive therapies of psoriasis may heighten your risk of lymphoma; however, at this point, the evidence is insufficient to recommend changes to your psoriasis medication regime.
3Opt for regular skin screening by a physician. If you are concerned about your risk for lymphoma, you can ask your doctor about coming in for periodic "cancer screening" exams. This may include a complete evaluation of your skin lesions, to ensure that all of them are related to psoriasis and not to a possible cancer, as well as an examination of your lymph nodes. This would not necessarily find a lymphoma if it was in a more deep lymph node that was not right under the skin, however, such as lymph nodes near the lungs or in the abdomen.Advertisement
Method Three of Three:
1Receive appropriate treatment if you are diagnosed with Hodgkin's lymphoma (HL). The mainstay of treatment for most cases of HL is chemotherapy. In some cases, radiation is given as a treatment for localized cases of HL that have not spread systemically throughout the body (i.e. where only one or a few lymph nodes appear to be affected, but the cancer is not widespread). Radiation may be given alone, or in combination with chemotherapy.
- A stem cell transplant may be considered as a form of treatment in severe cases of HL, or in recurrent cases that are unresponsive to initial treatment.
2Discuss the treatment options for CTCL with your doctor. In cutaneous T-cell lymphoma (CTCL), there are a variety of treatment strategies that may be tried. These range from topical treatments applied directly to the skin lesion(s), to phototherapy for the affected area, to localized radiation, to full-body chemotherapy, among other things.
- The best treatment for you, if you are in fact diagnosed with CTCL, will depend upon the extent of the cancer (and whether it is localized to a single skin lesion, or whether it has begun to spread throughout your body).
3Continue with your psoriasis treatments unless otherwise recommended by your doctor. Depending upon the type of cancer treatment you receive for your lymphoma, you may need to temporarily stop (or reduce) your psoriasis treatments; however, if they are stopped (for instance, during an intense period of chemotherapy), you will most likely be able to resume them following completion of the treatment.Advertisement