This 59-year-old man developed an erythroderma 5 weeks before admission to the hospital. He was on atenolol which was discontinued 10 days before admission. A skin biopsy, Sezary cell count, CD4/CD8 ratio were consistent with Sezary syndrome, but a T-cell clone was not identified. The patient gradually cleared with topical steroids, oral acitretin 50 mg daily, and lubricants. Sezary cells have been reported in benign disorders including chronic dermatoses such as psoriasis and atopic dermatitis as well as lichen planus, discoid lupus, pityriasis lichenoides, actinic reticuloid, and drug reactions from dilantin and minocycline. Malignant conditions associated with Sezary cells include cutaneous T-cell lymphoma and Sezary syndrome, B-cell lymphoma, and basal cell carcinoma. This man had a Sezary-like syndrome without evidence of malignancy and did well.
