Presentation
Here, we report a case of a 49-year-old Japanese man with SS who did not present with erythroderma initially, but exhibited erythematous itchy papules symmetrically located on the legs and arms. [ncbi.nlm.nih.gov]
Entire Body System
- Lymphadenopathy
Clinical Information A form of cutaneous t-cell lymphoma manifested by generalized exfoliative erythroderma; pruritus; peripheral lymphadenopathy, and abnormal hyperchromatic mononuclear (cerebriform) cells in the skin, lymph nodes, and peripheral blood [icd9data.com]
Definition / general Sézary syndrome (SS) is defined by the triad of erythroderma, generalized lymphadenopathy and the presence of clonally related neoplastic T cells with cerebriform nuclei (Sézary cells) in skin, lymph nodes and peripheral blood In [pathologyoutlines.com]
Sézary syndrome is a primary cutaneous T-cell lymphoma characterized by the triad of erythroderma, lymphadenopathy and circulating atypical cells. [ncbi.nlm.nih.gov]
A 66 year old man presented with asymptomatic multiple papules, plaques and nodules and with generalized lymphadenopathy. Peripheral smear showed more than 60% of Sezary cells. [ijdvl.com]
- Fever
The most commonly reported serious reactions are pneumonia (infection of the lungs), fever, infusion-related reactions and cellulitis (inflammation of the deep skin tissue). [ema.europa.eu]
Other signs and symptoms may include intense itchiness, scaling and peeling of the skin; fever; weight loss; hair loss; outward turning of the eyelids (ectropion); palmoplantar keratoderma; malformation of the nails; and hepatosplenomegaly. [diseaseinfosearch.org]
He had no history of fever, night sweats, weight loss, jaundice, cough, joint pain, previous allergy or any other systemic symptoms. [omicsgroup.org]
In contrast, Lundin et al. 20 reported grade 3 rigors in 18% of patients, grade 1–2 fever in 68%, grade 3 fever in 5%, and grade 3 fatigue in 9% of patients. [haematologica.org]
- Constitutional Symptom
symptoms and require rapid tumor reduction. [bloodjournal.org]
Special attention should be paid to constitutional symptoms, such as fevers, chills, fatigue, weight changes, night sweats, and lymphadenopathy. Typically, patients with CTCL lack these systemic signs upon presentation. [nursingcenter.com]
Cardiovascular
- Heart Disease
Association class III or IV heart disease No clinically significant peripheral venous insufficiency Other: HIV negative No poorly controlled diabetes mellitus No acute infection requiring IV antibiotics No other medical condition that would prevent ingestion [clinicaltrials.gov]
This method helps to sub-classify the condition and also to detect residual levels of disease after treatment. [dovemed.com]
Skin
- Pruritus
Serum samples from the peripheral blood of 23 patients and 17 controls were analyzed for IL-31 abundance and correlated with disease stage and pruritus. [ncbi.nlm.nih.gov]
The patient experiences pruritus, alopecia, edema, and nail and pigment changes. Sézary syndrome Sezary syndrome Mycosis fungoides, see there. [medical-dictionary.thefreedictionary.com]
- Alopecia
The patient experiences pruritus, alopecia, edema, and nail and pigment changes. Sézary syndrome Sezary syndrome Mycosis fungoides, see there. [medical-dictionary.thefreedictionary.com]
We describe a case of a delayed diagnosis of Sezary syndrome in a patient with longstanding generalised pruritus, erythroderma, alopecia and nail dystrophy. [ncbi.nlm.nih.gov]
Alopecia and ectropion are common, exfoliation and heat loss thru the skin are worrisome and infiltration of the lymph nodes occurs. Many of these patients have generalized pruritus and shaking chills at presentation. [dermnet.com]
Mycosis fungoides-associated follicular mucinosis : must be distinguished from benign follicular mucinosis / "alopecia mucinosa". [e-immunohistochemistry.info]
- Skin Plaque
plaques make response more likely. [emedicine.com]
Sézary syndrome is staged as follows: 1A: Less than 10 percent of the skin is covered in red patches or plaques. 1B: More than 10 percent of the skin is red. 2A: Any amount of skin is involved. [healthline.com]
Presence/absence of hypo- or hyperpigmentation, scale, crusting, and/or poikiloderma should be noted.cFor skin, plaque indicates any size skin lesion that is elevated or indurated. [es.oncolink.org]
- Plantar Hyperkeratosis
hyperkeratosis, onychodystrophy, leonine facies (resembles a lion) Associated with monoclonal gammopathy and secondary neoplasms (carcinoma, other non-Hodgkin lymphomas), attributed to the loss of normal circulating CD4+ cells Skin lesions rarely become [pathologyoutlines.com]
Neurologic
- Irritability
Likely increased risk of melanoma Topical Imiquimod Irritation Total skin electron beam (TSEB) Irritant dermatitis Table II. [clinicaladvisor.com]
Local application site erythema can develop, although irritant and contact reactions occur less often. In current care practice, carmustine is rarely, if ever, selected as an alternative to NM. [nursingcenter.com]
Topical treatment in SS can be extremely helpful and includes supportive therapies that minimize skin irritation, provide lubrication and adequate hydration, and ameliorate inflammation. 14 Skin exfoliation results in a violated protective barrier leaving [ispub.com]
- Perseveration
That individual has persistence, perseverance, and courage. Well, I may be an amateur cyclist, but I have my own Polka Dot Jersey, given to me by my friends. [giftoflife.org]
Workup
Currently, the disappearance of markers such as CD26, CD27 and CD7 from the cell surface of malignant T lymphocytes remains the most consistent feature of CTCL and is routinely used in the diagnostic workup. [atlasofscience.org]
(See Pathophysiology, Etiology, Presentation, and Workup.) Patch-stage mycosis fungoides. Plaque-stage mycosis fungoides. Hypopigmented cutaneous T-cell lymphoma. Courtesy of Jeffrey Meffert, MD. [emedicine.medscape.com]
Lymphomas/European Organization of Research and Treatment of Cancer (ISCL/EORTC) and the American Joint Committee on Cancer recommend assessment of T-cell immunophenotype, including CD26 and CD7, by peripheral blood flow cytometry during the staging workup [ajcp.oxfordjournals.org]
Treatment
Treatment Options by Stage For information about the treatments listed below, see the Treatment Option Overview section. [cancer.gov]
The treatment was discontinued after 4 months due to adverse effects, with the patient showing a sustained response without disease progression after 13 months of follow-up. [ncbi.nlm.nih.gov]
Prognosis
Many other clinical, biological and pathological factors may help to distinguish groups at risk and predict prognosis more accurately. [ncbi.nlm.nih.gov]
It presents suddenly and is associated with a poor prognosis. Clinical recognition is crucial for the diagnostic process and initiation of appropriate treatment. [doi.org]
Etiology
We then discuss updates in the etiology of this elusive disease and the genetic and molecular landscapes that define it. [ncbi.nlm.nih.gov]
Etiology SS has been linked to a wide range of chromosomal anomalies, in particular rearrangements in the 6q23-27 region leading to alterations in the MYB proto-oncogene and the interleukin-22 receptor subunit alpha-2 gene ( IL22RA2 ), but its etiology [orpha.net]
Epidemiology
We begin by providing an overview of the diagnostic criteria for SS and reviewing some of its epidemiological and clinical aspects. [ncbi.nlm.nih.gov]
Macit Ilkit and Murat Durdu, Tinea pedis: The etiology and global epidemiology of a common fungal infection, Critical Reviews in Microbiology, 41, 3, (374), (2015). M. Duvic, L. C. Pinter-Brown, F. M. Foss, L. Sokol, J. L. Jorgensen, P. [doi.org]
Case Name (click to open) Comments Size Case 28 Mycosis Fungoides / Seazary Syndrome 702 kB Epidemiology It is rare for the disease to appear before age 20, and it appears to be noticeably more common in males than females, especially over the age of [wiki.clinicalflow.com]
Pathophysiology
The pathophysiologic mechanisms that cause and result in different behaviors of the skin-homing-malignant T cells in different stages of cutaneous T-cell lymphoma (CTCL) are still unknown. [ncbi.nlm.nih.gov]
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test Sezary syndrome is a leukemic form of cutaneous T-cell lymphoma (CTCL). [mayomedicallaboratories.com]
(See Pathophysiology, Etiology, Presentation, and Workup.) Patch-stage mycosis fungoides. Plaque-stage mycosis fungoides. Hypopigmented cutaneous T-cell lymphoma. Courtesy of Jeffrey Meffert, MD. [emedicine.medscape.com]
Prevention
Despite its utility and duration of use, the current practice of using UVL guidelines for psoriasis to treat patients with MF/SS is problematic because the goals of prolonging survival and preventing disease progression are unique to CTCL compared to [ncbi.nlm.nih.gov]
Radiation therapy – A treatment that aims to kill cancer cells or prevent them from growing through high-energy x-rays. Chemotherapy – The use of drugs to prevent the cancer cells from growing by killing them or stop them from dividing. [syndromespedia.com]
Funding for this work came from National Human Genome Research Institute(Grant 5U54HG003273) and the Cancer Prevention and Research Institute of Texas (Grant: RP121018), the Drs. [bcm.edu]
How can Sézary Syndrome be Prevented? Currently, the cause of Sézary Syndrome is unknown. Hence, there are no known methods to prevent the tumor occurrence. Eliminating the modifiable risk factors may help in preventing the condition. [dovemed.com]