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A 58-year-old man presen ts with generalized erythroderma with associated pruritis. weigh t loss . and cold intolerance. In addition to the generalized skin changes. he has generalized lymphadenopathy and hyperkeratosis of the palms and soles on physical exam. Com plete blood count shows leukocyte count of 22. 300/,LLL. hemoglobin 1 2 .6 g/dl. and platelet count 1 6LJ .OOO/pl. Peripheral blood smear is shown below.
What is the most important clinical aspect affecting the prognosis of patients with SS?
- Type of TCR gene rearrangement
- Number of involved lymph node sites
- Hyperkeratosis of palms and soles
- Number of Sezary cells in the peripheral blood
Medicine
D. The number of Sezary cells in the peripheral blood has been reported to be a significant prognostic factor (median OS of 7.6 years for patients with less than 1 000/ ,LLL vs. 2.4 years for greater than 10,000/ ,LLL). Other factors that influence prognosis include advanced age, elevated LDH, and vis-ceral involvement (Int l Dermatol. 2009;4S(3):243-252).
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