Symptoms of CTCL can differ greatly, depending on the disease type and stage. The most common type is mycosis fungoides, whose symptoms progress slowly through three separate phases.
First phase: Red rash or dry, red, scaly patches of skin usually on the buttocks and trunk. These patches may remain and not change, may go away on their own, or slowly get larger. In this phase, the skin resembles psoriasis and it may remain this way for months, years or decades.
Second phase: Raised up, reddish-brown, scaly bumps (plaques) appear. These plaques may develop out of pre-existing patches or in previously unaffected areas. Over time they may grow together and form larger plaques. Any part of the body may be affected.
Severe itchiness and pain might also be present in the first two phases, but not all people experience this.
Third phase: Development of mushroom-shaped tumors. In some cases they may break open (ulcerate) or become infected. Some people develop tumors without ever experiencing the symptoms of the first two phases.
In about 10 percent of mycosis fungoides cases, lymphocytes spread from the skin into lymph nodes and/or internal organs such as the liver, spleen or digestive system. This could present a life-threatening situation.
Sézary syndrome is a rare form of CTCL. It is marked by the presence of cancerous lymphocytes in the bloodstream, and enlarged lymph nodes. Severe itching, and thickening, scaling and peeling of the skin may be present. Other symptoms include outward-turning eyelids, malformed nails, bald patches on the head, fevers, and general fatigue.