Guilhou J J, Meynadier J, Clot J
Nouv Presse Med. 1978 Jan 7;7(1):29-34.
The syndrome described in 1938 by Sézary and Bouvrain is characterized by a possibly hyperpigmented erythroderma with oedema and infiltration of the skin, palmo-plantar keratoderma, diffuse alopecia and large lymphadenopathies. The cutaneous histopathology frequently shows a dermal mononuclear infiltrate with, sometimes, epidermal microabcesses. But none of these signs is actually specific for the Sézary syndrom, the only criteria of which is the presence of circulating Sézary cells with their folded, cerebriform nucleus demonstrated by electron microscopy. The Sezary cell is to date clearly identified as a T lymphocyte but membrane markers and Tcell fonction studies could elicite abnormal and poor reactive T cell. In order to assert the Sézary Syndrome it is stated by the authors that the erythroderma must be associated with more than 10% of Sézary cells in peripheral blood. This feature is needed to differentiate the Sézary syndrome from the erythrodermic form of mycosis fondoïdes in which the abnormal T cell proliferation is mainly located in the skin. The relationship with the T cell chronic lymphatic leukemia and the main treatments of the Sezary syndrome are discussed.
1938年,塞扎里(Sézary)和布夫兰(Bouvrain)描述的该综合征的特征为:可能伴有色素沉着的红皮病,伴有皮肤水肿和浸润、掌跖角化病、弥漫性脱发以及巨大淋巴结病。皮肤组织病理学检查常显示真皮单核细胞浸润,有时可见表皮微脓肿。但实际上这些体征都并非塞扎里综合征所特有,其唯一标准是循环中存在塞扎里细胞,通过电子显微镜可显示其折叠的脑回状核。迄今为止,塞扎里细胞已明确被鉴定为T淋巴细胞,但膜标志物和T细胞功能研究可能会引发异常且反应性差的T细胞。为确诊塞扎里综合征,作者指出红皮病必须与外周血中超过10%的塞扎里细胞相关。这一特征用于将塞扎里综合征与蕈样肉芽肿的红皮病形式相区分,在蕈样肉芽肿中异常T细胞增殖主要位于皮肤。文中还讨论了与T细胞慢性淋巴细胞白血病的关系以及塞扎里综合征的主要治疗方法。