Scalp Involvement in Primary Cutaneous Lymphomas—An Update on Clinical Presentation, Diagnostics, and Management
Simple Summary
Abstract
1. Introduction
2. Materials and Methods
3. Results
3.1. Frequency and Epidemiology of Scalp Involvement in PCLs
3.2. Pathogenesis of PCLs Involving the Scalp
3.3. Scalp Involvement as a Prognostic Factor in PCL Patients
3.4. Clinical Presentation of CBCLs and CTCLs—An Overview
3.4.1. Clinical Presentation of PCLs Most Commonly Affecting the Scalp
Primary Cutaneous Follicle Center Lymphoma (PCFCL)
Primary Cutaneous Diffuse Large B-Cell Lymphoma (PCDLBCL)
Scalp Involvement in the Course of Other Cutaneous B-Cell Lymphomas (CBCLs)
Primary Cutaneous T-Cell Lymphoma of the Scalp
Folliculotropic Mycosis Fungoides (FMF)
Mycosis Fungoides (MF) and Sézary Syndrome (SS)
Scalp Involvement in Other PCLs
4. Diagnosis
4.1. Medical History
4.2. Physical Examinations and Laboratory Tests
4.3. Scalp Examination
4.4. Significance of Trichoscopy (Dermoscopy of the Scalp) in Diagnostics of PCLs
5. Differential Diagnosis
6. Treatment
7. Limitations
8. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristic | Number |
---|---|
Total number of patients—no. | 1482 |
Patients of known gender—no. | 502 |
Female—no. (%) | 167 (33.2) |
Male—no. (%) | 335 (66.8) |
Mean age at disease onset [years] | 49.1 |
Patients with cutaneous B-cell lymphoma (CBCL) no. (% of total) | 1096 (73.9) |
Primary cutaneous follicle center lymphoma (PCFCL)—no. (% of CBCL no.) | 711 (64.8) |
Primary cutaneous diffuse large B-cell lymphoma (PCDLBCL)—no. (% of CBCL no.) | 245 (22.3) |
Primary cutaneous marginal zone lymphoma (PCMZL)—no. (% of CBCL no.) | 107 (9.7) |
Other CBCL—no. (% of CBCL no.) | 33 (3.2) |
Patients with cutaneous T-cell lymphoma (CTCL) no. (% of total) | 384 (23.8) |
Mycosis fungoides (MF)—no. (% of CTCL no.) | 347 (90.4) |
Sézary Syndrome (SS)—no. (% of CTCL no.) | 10 (2.6) |
Primary cutaneous anaplastic large cell lymphoma (PCALCL)—no. (% of CTCL no.) | 9 (2.3) |
Lymphomatoid papulosis (LyP)—no. (% of CTCL no.) | 2 (0.5) |
Other CTCL—no. (% of CTCL no.) | 16 (4.2) |
Alopecia status during follow-up—no. of known cases | 426 |
Alopecia—no. (%) | 294 (69.0) |
No signs of alopecia—no. (%) | 132 (31.0) |
Characteristic/Variable | CBCLs | CTCLs |
---|---|---|
Total number of patients no. (%) | 1096 (73.9) | 384 (25.9) |
Patients of known gender no. | 123 | 379 |
Female—no. (%)/Male—no. (%) | 47 (38.2)/76 (61.8) | 120 (31.7)/259 (68.3) |
Female/Male ratio | 0.6 | 0.5 |
Mean age at disease onset [years] | 41.4 | 54.5 |
Alopecia status during follow-up no./total no. of known cases (%) | 54/76 (71.1) | 240/350 (68.6) |
Alopecia in variants—variant no./total no. (%) | PCFCL, 37/47 (78.7) | MF excluding FMF, 32/48 (66.7) |
PCDLBCL, 9/10 (90.0) | FMF, 185/274 (67.5) | |
PCMZL, 1/3 (33.4) | SS, 7/7 (100) | |
Other CBCL a, 7/16 (43.8) | PCALCL, 5/8 (62.5) | |
- | LyP, 0/1 (0) | |
- | Other CTCL a, 11/12 (91.7) |
Characteristic | Number |
---|---|
Cicatricial alopecia no. (%) a | 40 (40.0) |
Non-cicatricial alopecia no. (%) a | 60 (60.0) |
Patched alopecia no. (%) a | 101 (87.8) |
Diffuse alopecia no. (%) a | 14 (12.2) |
Erythema no. (%) b | 53 (11.5) |
Patches no. (%) b | 127 (27.7) |
Plaques no. (%) b | 157 (34.2) |
Papules no. (%) b | 124 (27.0) |
Nodules no. (%) b | 109 (23.7) |
Ulcerated tumors no. (%) b | 81 (17.6) |
Non-ulcerated tumors no. (%) b | 82 (17.9) |
Characteristic | CBCLs | CTCLs |
---|---|---|
Cicatricial alopecia no. (%) | 20 (50.0) | 20 (50.0) |
Non-cicatricial alopecia no. (%) | 17 (28.4) | 43 (71.6) |
Patched alopecia no. (%) | 45 (44.6) | 56 (55.4) |
Diffuse alopecia no. (%) | 2 (14.3) | 12 (85.7) |
Erythema no. (%) | 34 (64.2) | 19 (35.8) |
Patches no. (%) | 8 (6.3) | 119 (93.7) |
Plaques no. (%) | 17 (10.8) | 140 (89.2) |
Papules no. (%) | 23 (18.5) | 101 (81.5) |
Nodules no. (%) | 29 (26.6) | 80 (73.4) |
Ulcerated tumors no. (%) | 11 (13.6) | 70 (86.4) |
Non-ulcerated tumors no. (%) | 17 (20.7) | 65 (79.3) |
Clinical Characteristic of Scalp PCL | Differential Diagnosis |
---|---|
Cicatricial alopecia |
|
Non-cicatricial alopecia |
|
Patchy alopecia |
|
Diffuse alopecia |
|
Diffuse desquamative lesions |
|
Erythema/macules and patches |
|
Plaques, papules, nodules, and tumors |
|
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Kołkowski, K.; Sławińska, M.; Zagórska, B.; Nowicki, R.J.; Jankau, J.; Sokołowska-Wojdyło, M. Scalp Involvement in Primary Cutaneous Lymphomas—An Update on Clinical Presentation, Diagnostics, and Management. Cancers 2025, 17, 1678. https://doi.org/10.3390/cancers17101678
Kołkowski K, Sławińska M, Zagórska B, Nowicki RJ, Jankau J, Sokołowska-Wojdyło M. Scalp Involvement in Primary Cutaneous Lymphomas—An Update on Clinical Presentation, Diagnostics, and Management. Cancers. 2025; 17(10):1678. https://doi.org/10.3390/cancers17101678
Chicago/Turabian StyleKołkowski, Karol, Martyna Sławińska, Beata Zagórska, Roman J. Nowicki, Jerzy Jankau, and Małgorzata Sokołowska-Wojdyło. 2025. "Scalp Involvement in Primary Cutaneous Lymphomas—An Update on Clinical Presentation, Diagnostics, and Management" Cancers 17, no. 10: 1678. https://doi.org/10.3390/cancers17101678
APA StyleKołkowski, K., Sławińska, M., Zagórska, B., Nowicki, R. J., Jankau, J., & Sokołowska-Wojdyło, M. (2025). Scalp Involvement in Primary Cutaneous Lymphomas—An Update on Clinical Presentation, Diagnostics, and Management. Cancers, 17(10), 1678. https://doi.org/10.3390/cancers17101678