Figure 1: Clinical image
Note the widespread redness and scaling of skin, consistent with erythroderma, a characteristic feature of Sezary syndrome. Patients often experience persistent itching.
Figure 2: Peripheral blood smear
Note the medium-sized atypical lymphoid cells (Sezary cells) with convoluted (Top left image), cerebriform (Top right image) and clefted nuclei (Bottom image).
Figure 3: Flow plots-CD4 versus CD8
Flow cytometry on peripheral blood demonstrating an expanded population of CD4 T-cells (green population) with significantly increased CD4/CD8 ratio of 46:1 (>10:1).
Figure 4: Flow plots- CD7 vs CD26
The plot on the left shows abnormal CD4+ T-cell population (green population) that is negative for CD7 whereas the normal CD8+ T-cells (red population) are positive for CD7 expression.
The plot on the right shows that the abnormal CD4+ T-cell population (green population) is additionally negative for CD26 expression.