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

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.