A 53-year-old white woman presented to our clinic with Sézary syndrome. A buffy coat analysis of multiple fixed slides revealed a circulating Sézary cell count of 40% to 55%. Flow cytometry revealed an elevated CD4:CD8 ratio of 30:1. Therapy was begun with extracorporeal photopheresis, psoralen–UV-A, and interferon alfa-2b, 1.8 million units injected subcutaneously 3 times weekly. Oral bexarotene, 150 mg daily, was added 2 months later. On this regimen, the patient’s erythroderma and pruritus improved over a period of 3 months.
McGinnis KS, Ubriani R, Newton S, Junkins-Hopkins JM, Vittorio CC, Kim EJ, Wysocka M, Rook AH. The Addition of Interferon Gamma to Oral Bexarotene Therapy With Photopheresis for Sézary Syndrome. Arch Dermatol. 2005;141(9):1176–1178. doi:10.1001/archderm.141.9.1176