Sézary cell count in exfoliative dermatitis

Area of Science:

• Dermatology
• Oncology
• Pathology

Background:

• Sézary syndrome is a rare cutaneous T-cell lymphoma.
• Diagnosis can be challenging, often involving Sézary cell counts and skin biopsy findings.
• Distinguishing Sézary syndrome from other erythroderma conditions is critical.

Purpose of the Study:

• To evaluate the diagnostic significance of Sézary cell counts in various dermatoses.
• To determine the relationship between Sézary cell counts, histopathology, and the diagnosis of Sézary syndrome.
• To clarify the nature of Sézary syndrome, particularly its association with mycosis fungoides.

Main Methods:

• Retrospective analysis of 78 cases with benign dermatoses and mycosis fungoides.
• Assessment of Sézary cell counts in peripheral blood.
• Histopathological examination of skin biopsy specimens.

Main Results:

• Sézary cells (<1000/mm3) were found in 52 cases of benign dermatoses and mycosis fungoides.
• Elevated Sézary cell counts (>1000/mm3) were observed in two cases diagnosed as Sézary syndrome (mycosis fungoides histopathology) and six with exfoliative erythroderma (nonspecific dermatitis).
• Diagnosis of Sézary syndrome was not established in exfoliative erythroderma cases with high cell counts but absent abnormal cells in skin biopsies.

Conclusions:

• The absolute number of Sézary cells is not a definitive diagnostic criterion for Sézary syndrome.
• Skin biopsy confirmation of abnormal cells is essential for diagnosing Sézary syndrome.
• The study supports Sézary syndrome being an erythrodermic variant of mycosis fungoides, rather than a progression from exfoliative erythroderma.