Coexistence of Sezary syndrome with Kaposi's sarcoma: Report of a case with concurrent generalized dermatophyte infection

Immunosuppression is known to be associated with increased rate of malignancies and widespread dermatophytosis in the patients with sezary syndrome and this may account for the occurrence of Kaposi’s sarcoma and generalized dermatophytosis in patients in this report. Herein, we report a 58-year-old farmer man, who admitted with two months history of severely pruritic skin lesions, which progressed to erythroderma. Concurrently some vascular lesions were observed on glans penis off the patient suggestive of Kaposi’s sarcoma. Leukocytosis with eosinophilia (20%) and atypical lymphocytosis (More than 10%) were present. Microscopic examination of biopsy of erythrodermic skin lesions on trunk revealed pautrier micro abscess with dermal lymphocytic infiltration and cellular atypia, and the peripheral blood sample showing sezary cells and high ratio of CD4/CD8 (45) lymphocyte were in favor of diagnosis of sezary syndrome. The pathologic evaluation of the vascular lesion of glans penis proved the diagnosis of Kaposi’s sarcoma. During the progression of disease, the patient was invaded by generalized dermatophyte infection. KOH smear of annular skin lesion showed mycelia of dermatophyte and culture proved trichophyton rubrum to be the pathogenic agent.