cutaneous t-cell lymphoma

Sezary Syndrome is an uncommon leukemic variant of Cutaneous T-cell Lymphoma (CTCL), comprising only 5% of all CTCL cases. The rarity of this syndrome emphasizes the critical need to comprehend its distinct clinical presentation, diagnosis, and treatment.  

 A 51-year-old man was admitted with itchy, persistent, and extensive erythematous patches, ulcers, lumps, lymphadenopathy, alopecia, and nail dystrophy that had been present for eight months. Laboratory findings showed elevated LDH and 𝛽2-microglobulin. Peripheral blood smear analysis confirmed the presence of Sezary cells, while imaging revealed multiple lymph node enlargements. Skin biopsy and immunohistochemistry suggested cutaneous T-cell lymphoma (CTCL), while immunophenotyping verified a diagnosis of  Sezary syndrome . The patient underwent fluid therapy, systemic antibiotics, topical antibiotics, phototherapy, and chemotherapy. Tenofovir was given due to the hepatitis B co-infection. Despite the improvement when discharged from the hospital, the patient's health eventually deteriorated, which led to death at home.

This patient presented with Sezary Syndrome, exhibiting atypical dermatologic manifestations that must be differentiated from other causes of erythroderma. This case highlights the importance of a comprehensive diagnostic approach, including clinical evaluation, laboratory tests, imaging, and biopsies. Sezary Syndrome is an inherently aggressive malignancy, characterized by a poor response to treatment and a low 5-year survival rate.

During the current coronavirus disease 2019 (COVID-19) pandemic, patients with malignancies like primary cutaneouslymphomas (PCLs) are considered at high risk for severe disease progression given their underlying condition. Mycosis fungoides (MF) is a type of PCL that often needs lifelong treatments, including immunosuppressive drugs that predispose patients to catastrophic COVID-19 outcomes. Accordingly, several issues are to be addressed in the management of patients with MF. First of all, patients with this chronic condition may lose access to healthcare services such as phototherapy and inpatient treatments like electron beam therapy. Secondly, the patients’ anxiety of becoming infected while referring for the follow-up visits might impair their adherence to treatments. Finally, the current situation may affect the management strategies of dermatologists adopted for MF patients.We decided to perform this teledermatology study to assess the clinical condition of patients with MF in our referral center. We also evaluated patients’ perceived anxiety during the COVID-19 pandemic based on the Corona Disease Anxiety Scale (CDAS). Our results demonstrated that lockdown could influence adherence to treatment modalities (especially phototherapy) in these patients.

Mycosis fungoides (MF) is the most common type of cutaneous T-cell lymphoma, which often appears in the form of patches, plaques, and tumors as originally described by Alibert and Bazin. The manifestation of MF as annular lesions is uncommon, and herein we report one of those cases. A 54-year-old woman complaining of itchy skin lesions from three years before, came to our clinic with no response to topical steroids. In skin examination, there were annular lesions with erythematous slightly raised borders, and some scattered erythematous thin plaques in trunk and extremities with a predilection to lower extremities. Epidermal and poikilodermic changes were not evident. There were no lymphadenopathy and hepatosplenomegaly. Biopsies were obtained from three different lesions and the diagnosis of all samples was consistent with MF. A diagnosis of stage 1B of MF was made and the patient went under oral psoralen and ultraviolet A (PUVA) therapy. MF has different clinical manifestations that can be confused with other inflammatory dermatological disorders. Until now, less than 10 cases of MF with annular lesions have been reported in the English literatures, and most of them initially were under treatment with other differential diagnosis of annular lesion than MF