A Prospective Study of Cutaneous Intolerance to Topical Mechlorethamine Therapy in Patients With Cutaneous T-Cell Lymphomas

Treatment of Early-Stage Mycosis Fungoides With Twice-Weekly Applications of Mechlorethamine and Topical Corticosteroids

“…7,[11][12][13] Cutaneous intolerance to mechlorethamine (ie, irritant and/or allergic dermatitis) represents a frequent and major adverse reaction, since it occurs in 30% to 80% of patients and often leads to treatment discontinuation. 7,[14][15][16][17] Moreover, the need for daily applications is another disadvantage of this treatment. 18 We tested the hypothesis that reducing the frequency of mechlorethamine applications and following these by an application of topical corticosteroids could decrease the frequency of cutaneous reactions of intolerance to mechlorethamine.…”

“…Because clinical and histologic interpretation of skin patch test results is difficult in patients with a cutaneous reaction of intolerance to mechlorethamine, 17 skin patch tests were not routinely performed in these patients. Even in patients with clear spongiotic dermatitis, it is not clear whether mechlorethamine applications should be discontinued.…”

“…[11][12][13][14][15] Nevertheless, this treatment is responsible for numerous cutaneous reactions of intolerance (ie, allergic and irritant dermatitis). [15][16][17] This condition has been reported to occur in up to 80% of patients, and frequently mechlorethamine therapy is discontinued. [9][10][11]14,17 Moreover, the need for daily applications is another drawback of this treatment, since it may impair patients' quality of life and necessitate expensive nursing care.…”

“…[15][16][17] This condition has been reported to occur in up to 80% of patients, and frequently mechlorethamine therapy is discontinued. [9][10][11]14,17 Moreover, the need for daily applications is another drawback of this treatment, since it may impair patients' quality of life and necessitate expensive nursing care. 18 The present study was thus designed to test the hypothesis that a therapeutic regimen of twice-weekly applications of mechlorethamine and topical corticosteroids could be an effective treatment for patients with early-stage MF while decreasing the incidence of severe cutaneous intolerance reactions.…”

“…[14][15][16][17] The most frequently observed cutaneous reactions of intolerance include burning sensations, pruritus, and eczematous reactions. We recently reported a 53% rate of intolerance reactions to mechlorethamine in a series of 43 patients with MF treated with daily applications of mechlorethamine 17 ; 91% of these reactions occurred within the first 3 months of treatment. In the present study, we observed a lower rate of cutaneous intolerance reactions, since only 18 patients (28%) experienced a severe reaction to mechlorethamine that necessitated treatment withdrawal.…”