T-Cell Receptor-G Gene Rearrangement Analysis in the Diagnosis of Patients with Erythroderma / Dijagnostički Značaj Analize Preuređenja Gena Gama Lanca T-Ćelijskog Receptora Kod Pacijenata Sa Eritrodermijom

The diagnosis of erythroderma is challenging, since clinical, histopathological and immunophenotypic findings are insufficient to differentiate between inflammatory and lymphomatous erythroderma. Thus, multiplex PCR was used for T-cell receptor-γ gene rearrangement analysis, in the skin and peripheral blood samples of 24 patients (20 men and 4 women) with erythroderma of varying origin, in order to estimate its diagnostic value. Cutaneous T-cell lymphoma was confirmed in 9, benign inflammatory dermatosis in 12, and idiopathic erythroderma and clonal dermatitis in 3 patients. In the group of patients with erythrodermic cutaneous T-cell lymphoma, the dominant clone was detected in the skin of 8/9, and in none of the patients with inflammatory dermatoses. A dominant clone was found in peripheral blood of 5/6 samples of patients with erythrodermic cutaneous T-cell lymphoma, and in 2/12 patients with inflammatory dermatosis. T-cell receptor-γ gene rearrangement analysis is valuable in differentiation between inflammatory and lymphomatous erythroderma, thus substantially improving the diagnosis of patients with erythroderma.