Lymphoma Misdiagnosed in RSS

Over the past 18 months I have treated four patients who had been misdiagnosed with lymphoma of the skin and /or Sezary syndrome, an end stage form of lymphoma. None of the four patients I treated had corroboratory lab studies – no skin biopsy proven lymphoma or any blood study showing lymphoma cells, or lymph node pathology showing lymphoma. All four were eczema patients for many, many years and were topical corticosteroid addicted patients suffering with Red Skin Syndrome (RSS), a completely curable condition through complete withdrawal from steroids.

With 40 years of steroïden online in nederland practicing medical dermatology, and treating probably 200,000 patients, I have never seen a case of Sezary syndrome or red, exfoliative skin secondary to lymphoma. I have been told of three other patients with this diagnosis and have strong suspicions about them being misdiagnosed as well. I am told that one of them had four negative skin biopsies and no abnormal blood cells. Still they are being told they have this very frightening fatal diagnosis.

I know of no recent published papers discussing new findings to support this diagnosis. Are we to suppose that there is a sudden outbreak of an exceptionally rare syndrome? These unfortunate patients were given a fatal diagnosis, totally without foundation, other than their skin was extensively red and got worse symptomatically but not pathologically. These are the hallmarks of Red Skin Syndrome!

The four patients I treated were steroid addicted – there never was lymphoma – they recovered fully with steroid cessation.

By Dr Marvin Rapaport, MD|2021-10-19T03:16:45-07:00November 7th, 2018|Red Skin Syndrome|Comments Off

About the Author: Dr Marvin Rapaport, MD

In 1978 I initiated and set up the contact and photo dermatitis clinic at UCLA. There was a need to evaluate a large group of patients who exhibited severe eczematoid rashes, especially on the face. Patients were referred from all over Southern California. All patients underwent a lengthy history and examination. Further evaluations included blood studies, allergy patch testing, special sunlight (photo) testing and skin biopsies. From the start it was apparent that most patients experienced a mild dermatitis on various parts of the body that progressively worsened. Their histories always included numerous doctor visits, multiple physicians, and therapy consisting of an increasing amount of corticosteroids. My testing failed to reveal any specific culprit chemicals, cosmetics, perfumes, workplace or recreational exposures. It became increasingly clear that the physician’s therapy, the corticosteroids, was invariably causing the problem. I wrote 7 scientific articles that were published in the most august peer-reviewed dermatologic journals and I gave many lectures at various dermatology meetings. To this day an unfortunate reluctance exists on the part of most physicians to accept this simple concept.