Drug-induced pseudo-Sezary syndrome: a case report and literature review

Am J Dermatopathol. 2015 Jan;37(1):83-6. doi: 10.1097/DAD.0000000000000169.

Abstract

Pseudo-Sezary syndrome is a benign lymphoproliferative disorder, which clinically and pathologically mimics true Sezary syndrome. In this article, a case of pseudo-Sezary syndrome and review the literature has been reported. The patient was a 51-year-old man who developed erythroderma and palmoplantar keratoderma. The patient's medication history included fosinopril and combination metoprolol/hydrochlorothiazide. Flow cytometry showed a population of 2500 "Sezary-like" CD4726 T cells per microliter in the peripheral blood. Skin biopsy showed numerous atypical lymphocytes with epidermotropism, and there was matching dominant T-cell clonality in the skin and peripheral blood. After stopping all antihypertensive medications, the eruption resolved in its entirety.

Publication types

  • Case Reports
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Review

MeSH terms

  • Adrenergic beta-1 Receptor Antagonists / adverse effects
  • Angiotensin-Converting Enzyme Inhibitors / adverse effects
  • Antihypertensive Agents / adverse effects*
  • Biomarkers / analysis
  • Biopsy
  • Diagnosis, Differential
  • Diuretics / adverse effects
  • Drug Eruptions / etiology*
  • Drug Eruptions / genetics
  • Drug Eruptions / immunology
  • Drug Eruptions / pathology
  • Flow Cytometry
  • Fosinopril / adverse effects
  • Genes, T-Cell Receptor
  • Humans
  • Hydrochlorothiazide / adverse effects
  • Immunohistochemistry
  • Male
  • Metoprolol / adverse effects
  • Middle Aged
  • Predictive Value of Tests
  • Prognosis
  • Sezary Syndrome / diagnosis*
  • Sezary Syndrome / genetics
  • Sezary Syndrome / immunology
  • Sezary Syndrome / pathology
  • Skin / drug effects*
  • Skin / immunology
  • Skin / pathology
  • Skin Neoplasms / diagnosis*
  • Skin Neoplasms / genetics
  • Skin Neoplasms / immunology
  • Skin Neoplasms / pathology
  • T-Lymphocytes / drug effects*
  • T-Lymphocytes / immunology
  • T-Lymphocytes / pathology

Substances

  • Adrenergic beta-1 Receptor Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • Antihypertensive Agents
  • Biomarkers
  • Diuretics
  • Hydrochlorothiazide
  • Metoprolol
  • Fosinopril