Skin tumours: Sezary syndrome: practice question

A Dermatology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Dermatology · Skin tumours: Sezary syndrome

Sample item

A 65-year-old has diffuse erythroderma, severe itch, generalised lymphadenopathy and cells with cerebriform nuclei in peripheral blood. What is the diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Sezary syndrome

Sezary syndrome is a leukaemic variant of cutaneous T-cell lymphoma, with erythroderma, lymphadenopathy and circulating malignant CD4 T cells with cerebriform nuclei. Prognosis is poorer than for mycosis fungoides. Flow cytometry and T-cell receptor clonality help confirm it.

Option by option

  • A. Sezary syndrome (correct)

    Correct. Erythroderma with circulating cerebriform cells is Sezary syndrome.

  • B. Pityriasis rubra pilaris

    PRP shows islands of sparing and orange keratoderma.

  • C. Psoriatic erythroderma

    Psoriatic erythroderma has a history of psoriasis and no circulating malignant cells.

  • D. Atopic erythroderma

    Atopic erythroderma has a history of atopy without circulating atypical lymphocytes.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is A, Sezary syndrome. Sezary syndrome is a leukaemic variant of cutaneous T-cell lymphoma, with erythroderma, lymphadenopathy and circulating malignant CD4 T cells with cerebriform nuclei.

Why is "Pityriasis rubra pilaris" not the answer?

PRP shows islands of sparing and orange keratoderma.

Why is "Psoriatic erythroderma" not the answer?

Psoriatic erythroderma has a history of psoriasis and no circulating malignant cells.

Why is "Atopic erythroderma" not the answer?

Atopic erythroderma has a history of atopy without circulating atypical lymphocytes.

What concept does this question test?

It tests Skin tumours: Sezary syndrome in Dermatology. Prognosis is poorer than for mycosis fungoides. Flow cytometry and T-cell receptor clonality help confirm it.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Skin tumours: Sezary syndrome?

Learn each condition by its primary lesion, site and signature sign. Then use the flashcards and the other Dermatology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.