Sézary syndrome masquerading as palpebral dermatitis
Author: Estel·la Rojas
Base Hospital / Institution: Barraquer Ophthalmology Centre
ePoster presentation
Abstract ID: 25-147
Purpose
Sézary syndrome is an aggressive leukemic variant of cutaneous T-cell lymphoma (CTCL), whose initial presentation may mimic benign dermatologic conditions, leading to delayed diagnosis. We present the case of a patient initially diagnosed with dermatitis, who was ultimately found to have Sézary syndrome.
Methods
Case report.
Results
A 62-year-old male presented to the emergency department with bilateral eyelid edema, erythema, and pruritus of several months’ duration. Visual acuity was 20/20, and intraocular pressure was 14 mmHg in both eyes. The ocular examination revealed eyelid thickening, erythema, scaling, and edema bilaterally, while both the anterior and posterior segments were unremarkable. Differential diagnoses included allergic dermatitis, atopic dermatitis, blepharitis, and rosacea, but no conclusive findings were identified. Topical corticosteroids and emollients were prescribed, leading to transient improvement; however, symptoms recurred after treatment discontinuation.
At a follow-up visit, the patient reported new-onset pruritus in the extremities. Examination revealed erythematous plaques on the legs and arms, raising suspicion for CTCL. He was referred to a specialized center for cutaneous hematologic malignancies, where Sézary syndrome was confirmed via skin biopsy, immunohistochemistry, and immunophenotypic analysis.
Conclusion
CTCL is a rare neoplasm of helper T lymphocytes that can resemble dermatitis in its early stages, making timely diagnosis challenging. The disease progresses from patch-like lesions to indurated plaques and, in advanced stages, to ulcerated nodules. Other ocular manifestations may include corneal involvement and optic nerve edema. Recurrence after standard treatment and the appearance of lesions in other areas should raise clinical suspicion. Early biopsy of chronic or atypical lesions is essential for timely diagnosis, enabling appropriate treatment and improving patient outcomes.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Alejandro | Alcaide Costa | Barraquer Ophthalmology Centre |
