Immunologic Differentiation of the Sézary Syndrome Due to Cutaneous T-Cell Lymphoma and Chronic Actinic Dermatitis

• Published in: Journal of investigative dermatology Vol. 86; no. 2; pp. 134 - 137
• Main Authors: Chu, Anthony C, Robinson, Danielle, Hawk, John L M, Meacham, Robert, Spittle, Margaret F, Smith, Neil P
• Format: Journal Article
• Language: English
• Published: Danvers, MA Elsevier Inc 01.02.1986; Nature Publishing
• Subjects: Antibodies, Monoclonal - immunology; Biological and medical sciences; Chronic Disease; Cytology; Dermatitis; Dermatology; Diagnosis, Differential; Differentiation; Electron microscopy; Fluorescent Antibody Technique; Hematologic and hematopoietic diseases; Humans; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Leukocytes (mononuclear); Lymphadenopathy; Lymphocytes T; Lymphoma - complications; Lymphoma - immunology; Lymphoma - pathology; Medical sciences; Monoclonal antibodies; Peripheral blood mononuclear cells; Photosensitivity Disorders - complications; Photosensitivity Disorders - immunology; Photosensitivity Disorders - pathology; Sezary syndrome; Sezary Syndrome - etiology; Sezary Syndrome - immunology; Sezary Syndrome - pathology; Skin Neoplasms - complications; Skin Neoplasms - immunology; Skin Neoplasms - pathology; Suppressor cells; T-cell lymphoma; T-Lymphocytes - classification; Human; Sezary cell; Skin disease; Hemopathy; Monoclonal antibody; Indirect immunofluorescence; Lymphoma; Cell subpopulation; Differential diagnostic; Immunological method; Chronic; Photodermatosis; Immunology; Physical agent; Sezary syndrome; Immunological investigation; T-Lymphocyte; Skin
• ISSN: 0022-202X; 1523-1747
• DOI: 10.1111/1523-1747.ep12284160

Peripheral blood mononuclear cells from two well-defined groups of patients with the Sézary syndrome have been studied employing indirect immunofluorescent and indirect immunogold techniques in light and electron microscopy, using monoclonal antibodies against T-cell subpopulations. Four patients had chronic actinic dermatitis (CAD) of the actinic reticuloid variant, with erythroderma. Eight patients had cutaneous T-cell lymphoma. All patients showed the clinical features of the Sézary syndrome, including erythroderma, palmoplantar hyperkeratosis, and peripheral lymphadenopathy, and in all patients significant numbers (0.5–30.5 × 109 cells/liter) of circulating mononuclear cells were observed with Sézary cell morphology on light-microscopic examination of blood films. Major differences were observed in the circulating T-cell subpopulations in the two groups. In the erythrodermic CAD patients, there was a moderately elevated T-cell count (1 .6 ± 0.6 × 109 cells/liter; normal, 1.0 ± 0.3 × 109cells/liter) of which the majority of the cells was suppressor T cells (OKT8 +) giving a very low helper: suppressor T-cell ratio of 0.1: 1–0.36: 1 (normal, 1.7: 1–3.5: 1). In cutaneous T-cell lymphoma, there was also an elevation of the T-cell count (9.5 ± 12.9 × 109 cells/liter), but in these patients the predominant cell was the helper T cell (OKT4 +) with a high helper: suppressor T-cell ratio of 3.7: 1–98:1.