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.