• CASE REPORT
   

Beyond Eczema and Lupus: Sézary Syndrome with Chronic Cutaneous Presentation Mimicking Common Inflammatory Dermatoses
 

• Carmen Cecilia Tamara Ariza.1 Alexander Jesus Diaz Navarro.1 Marco Antonio Ditta Cassiani.1 Angelo Geovanni Arzuaga Hernández.2 Jose Francisco Vega Romero.3,4 María José Viera Contreras.5
  
  .1Internal medicine, Metropolitan University, Barranquilla, Colombia 
• .2Department of Rheumatology, Comprehensive Rheumatology Center of the Caribbean, Barranquilla, Colombia 
• .3Medicine, Sinu University, Cartagena, Colombia 
• .4Medicine, Metropolitan University, Barranquilla, Colombia 
• .5Internal medicine, Simon Bolivar University, Barranquilla, Colombia
  
  Corresponding Author: Carmen Cecilia Ariza Tamara. Metropolitan University, Barranquilla/Colombia, 76th Street No. 42-78 Garden City Neighborhood, Barranquilla, Atlántico. E-mail: [email protected]
  
  Received: November 11, 2025                                    Published: November 21, 2025
  
  Citation: Ariza Tamara CC. Beyond Eczema and Lupus: Sézary Syndrome with Chronic Cutaneous Presentation Mimicking Common Inflammatory Dermatoses. Int J Complement Intern Med. 2025;6(4):469–474. DOI: 10. 58349/IJCIM. 4. 6. 2025. 00166
  
  Copyright: ©2025 Ariza Tamara CC. This is an open access article distributed under the terms of the Creative Commons AttributionLicense, which permits unrestricted use, distribution, and build upon your work non-commercially.
  
  Abstract 

Sézary syndrome is an uncommon and aggressive leukemic variant of cutaneous T-cell lymphoma (CTCL), often misdiagnosed in its early stages due to its clinical resemblance to chronic inflammatory dermatoses such as eczema or cutaneous lupus erythematosus. We report the case of a 67-year-old woman who presented with chronic pruritic erythematous plaques initially diagnosed and treated as chronic eczema and later as systemic lupus erythematosus (SLE), delaying the correct diagnosis. The eventual identification of Sézary cells on peripheral smear and confirmatory immunophenotyping established the diagnosis of Sézary syndrome, underscoring the need for a high index of suspicion and a multidisciplinary diagnostic approach when evaluating chronic, treatment-refractory dermatoses.

References

1. Kraev K, Hristov B, Uchikov P, et al. Comprehensive exploration of antinuclear antibodies (ANAs): Unveiling clinical significance, associations with cancer, and the nuances of differential diagnosis in positive ANA patients. Diagnostics (Basel). 2024;14(3):320. 

2. Kempf W, Mitteldorf C. Cutaneous T-cell lymphomas—An update 2021. Hematol Oncol. 2021;39 Suppl 1:46–51. 

3. López LR, Merrill JT, Espinosa LR, et al. Antinuclear antibodies with a homogeneous and speckled immunofluorescence pattern are associated with lack of cancer while those with a nucleolar pattern with the presence of cancer. Front Med (Lausanne). 2020;7:165. 

4. Wang Y, Zhang C, Zhang Y, et al. Diagnostic Value and Clinical Association of Antinuclear Antibody Patterns in Patients with Malignancy. Diagnostics (Basel). 2024;14(3):320. 

5. Ramos-Casals M. Autoimmunity and cancer: systemic autoimmune diseases as paraneoplastic syndromes. Autoimmun Rev. 2017;16(9):935–944.

6. Scarisbrick JJ, Hodak E, Bagot M, et al. The importance of assessing blood tumour burden in cutaneous T-cell lymphoma. Br J Dermatol. 2020;183(5):846–854. 

7. Geller S, Lebowitz E, Pulitzer MP, et al. Early clinical manifestations of Sézary syndrome. J Am Acad Dermatol. 2017;77(4):617–624. 

8. Weiner DM, Rook AH. Cutaneous T-cell lymphoma. Hematol Oncol Clin North Am. 2024;38(5):1087–1110. 

9. Scarisbrick JJ, Bagot M, Ortiz-Romero PL, et al. Cutaneous lymphomas: ESMO Clinical Practice Guidelines. Ann Oncol. 2021;32(12):1515–1527. 

10. Zheng YY, Li Y, Chen MY, et al. A case report of widespread Majocchi's granuloma in a patient misdiagnosed with systemic lupus erythematosus. Ann Clin Microbiol Antimicrob. 2017;16(1):3. 

11. Jawed SI, Myskowski PL, Horwitz S, et al. Primary cutaneous Tcell lymphoma (mycosis fungoides and Sézary syndrome): part I. Diagnosis: clinical and histopathologic features and new molecular and biologic markers. J Am Acad Dermatol. 2014;70(2):205.e1–16. 

12. Brumbaugh B, Thompson B, Holt A, et al. Delays in diagnosis in cutaneous T-cell lymphoma: A retrospective study on clinical course and time to death. J Am Acad Dermatol. 2024;91(5):968– 970. 

13. Hague C, Farquharson N, Menasce L, et al. Cutaneous T-cell lymphoma: diagnosing subtypes and the challenges. Br J Hosp Med (Lond). 2022;83(4):1–7. 

14. Lebas E, Collins P, Somja J, et al. Causes of death in cutaneous T-cell lymphoma patients. Dermatology. 2023;239(6):860–7. 

15. Zic JA. Diagnosis and management of cutaneous lymphomas including cutaneous T-cell lymphoma. Med Clin North Am. 2021;105(4):737–755. 

16. Martini DJ, Goyal S, Switchenko JM, et al. African American and Caucasian patients with Sézary syndrome have no differences in outcomes at an ethnically diverse urban medical center. Leuk Lymphoma. 2022;63(9):2094–2101. 

17. Watanabe R. Sézary syndrome: Advances in understanding pathogenesis and potential therapies. Front Med (Lausanne). 2020;7:165.