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Primary cutaneous T-cell lymphomas (CTCLs) are Non-Hodgkin lymphomas where skin may be the only involved organ for a long time. The erythrodermic form of CTCL, including Sezary syndrome, with increased IgE concentration, eosinophilia and intense pruritus, may suggest atopic dermatitis, in the lack of evidence for diagnosis of T-cell lymphoproliferative disorder. After vigorous research, two patients with erythroderma, increased IgE and eosinophilia, were not diagnosed with CTCL. Adult atopic dermatitis was diagnosed, based on clinical examination and histopathologic analysis of the skin sample. Therapy with oral cyclosporin A (CsA) and systemic corticosteroids were initiated, but the improvement was minimal and short-lived. Disease progression was noted in both patients, after a month of cyclosporine therapy: malaise, subfebrile and febrile temperatures, and development of generalized skin nodules were evident. In the first patient (aged 30) repeated examinations confirmed presence of Sezary cells in peripheral blood samples, dominant T-cell clone in the skin, peripheral blood and bone marrow, whereas the last repeated histopathologic analysis revealed T-lymphoproliferative skin disorder. In the second patient, (aged 44) primary cutaneous CD30+ T-cell lymphoma was diagnosed, based on histopathologic analysis of the newly appearing skin nodule. Differential diagnosis of erythroderma is always difficult, since clinical, histopathologic and immunophenotypic findings are frequently insufficient to differentiate between inflammatory and lymphomatous erythroderma. Treatment with cyclosporin A always demands carefull evaluation of the course of the disorder. Sažetak Uvod: Primarni kutani limfomi T-ćelija su Non- Hočkinovi limfomi kod kojih koža može biti dugo jedini zahvaćeni organ. U nedostatku nalaza koji bi potvrdili limfoproliferativno oboljenje T-ćelija, eritrodermijski oblik ovih limfoma (uključujući i Sezarijev sindrom), uz visoke koncentracije IgE, eozinofiliju i izrazit svrab može da podseća na atopijski dermatitis. Prikaz slučaja: Dva bolesnika, hospitalizovana zbog eritrodermije, kod kojih opsežnim ispitivanjima nije dokazano limfoproliferativno oboljenje, pod dijagnozom eritrodermijskog adultnog atopijskog dermatitisa lečeni su oralnim ciklosporinom uz sistemske kortikosteroide, sa privremenim i minimalnim poboljšanjima. Bolest je kod oba bolesnika progredirala u vidu pogoršanja opšteg stanja, febrilnosti i pojave generalizovanih eritemolividnih nodusa. Kod prvog bolesnika ponovljenim ispitivanjima postavljena je dijagnoza Sezarijevog sindroma na osnovu histopatološkog nalaza kože koji je upućivao na T-limfoproliferativno oboljenje, nalaza Sezarijevih ćelija u razmazu periferne krvi i nalaza monoklonske populacije T-limfocita u koži, perifernoj krvi i kostnoj srži. Kod drugog bolesnika histopatološkom analizom jednog od novonastalih nodusa detektovan je periferni T-ćelijski limfom. Zaključak: Diferencijalna dijagnoza između inflamatorne dermatoze i eritrodermijskog primarnog T-ćelijskog limfoma uvek je teška i zahteva ponavljana ispitivanja sa ciljem dokazivanja mogućeg limfoma. Primena ciklosporina u terapiji uvek zahteva pažljivo praćenje toka bolesti.

Erythrodermic cutaneous T-cell lymphoma: Two case reports / Eritrodermalni kutani limfom T-ćelija - prikaz dva slučaja