Topical Use of Mechlorethamine in the Treatment of Psoriasis

Taylor, J. Richard; Halprin, Kenneth M.

doi:10.1001/archderm.1972.01620120050010

Cited by 25 publications

(3 citation statements)

References 4 publications

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“…Irritant dermatitis was observed in only two children (10%) and discontinuation of mustine was not required. The frequency of irritant or allergic contact dermatitis caused by mustine has been reported to be as high as 30–70% in adults,26 27 31 while others observed it in only 15% of their patients 21. It is often difficult to differentiate between irritant/toxic and allergic reactions to mustine 21.…”

Section: Discussionmentioning

confidence: 99%

Long term follow up of topical mustine treatment for cutaneous Langerhans cell histiocytosis

Hoeger

Nanduri²,

Harper³

et al. 2000

Archives of Disease in Childhood

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Background and objectives-Skin lesions in Langerhans cell histiocytosis (LCH) are often painful and diYcult to treat. Topical application of nitrogen mustard (0.02% mechlorethamine hydrochloride, mustine), an alkylating cytostatic agent, has been shown to be eVective. There is, however, concern about potentially harmful long term side eVects. Study design-In a retrospective study 20 children with LCH (average extent of initial skin involvement: 16.4% body surface) were followed up for an average of 8.3 years after completion of topical mustine therapy. They had received a total of 34 courses (mean duration 14.2 weeks) of topical mustine. Disease status on follow up was assessed according to the Histiocyte Society classification. Results-After mustine was introduced, 16 patients were able to discontinue systemic steroids and/or chemotherapy. Topical mustine was well tolerated in 18 patients, but two developed irritant dermatitis. On follow up, the disease was inactive in 10 patients. Among the children with active disease, six had mild skin disease and four had progressive disease, two of them with skin lesions unresponsive to mustine treatment. Scars confined to areas of formerly active skin disease were found in six patients. There was no evidence of premalignant or malignant skin disease in the treated areas. Conclusion-Topical mustine is an eVective and safe treatment for skin disease in most children with LCH. Residual scarring was probably a result of the disease itself rather than to mustine. Although no evidence of skin cancer was found in this study, continued long term follow up is advisable. (Arch Dis Child 2000;82:483-487)

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Section: Discussionmentioning

confidence: 99%

Long term follow up of topical mustine treatment for cutaneous Langerhans cell histiocytosis

Hoeger

Nanduri²,

Harper³

et al. 2000

Archives of Disease in Childhood

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“…The response was good in 10, but nine developed hypersensitivity reactions during eight months. Further reports have followed (Mandy, Taylor and Halprin, 1971 ;Zackheim, Arnold, Farber and Cox, 1972 ;Taylor and Halprin, 1972). About 80 cases were treated by these authors, and over 50% developed hypersensitivity of a degree sufficient to force withdrawal of the method.…”

Section: Introductionmentioning

confidence: 99%

Topical Mustine Hydrochloride and Psoriasis

Purdy¹

1973

Australas J Dermatol

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“…Although nitrogen mustard (mechlorethamine, HN2) has been found to be effective in the topical treatment of both psoriasis (Mandy, Taylor & Halprin, 1971;Taylor & Halprin, 1972) and mycosis fungoides (Van Scott & Winters, 1970;Van Scott & Kalmanson, 1973;Price et al, 1977), the development of delayed contact hypersensitivity is a common occurrence (Waldorf, Haynes & Van Scott, 1967;Taylor & Halprin, 1972;Breza, Kechijian & Taylor, 1975;Pariser et al, 1976). Attempts at desensitization to HN2 have been variably successful in the past (Waldorf et al, 1967;Van Scott & Kalmanson, 19735 Breza et al, 1975;Pariser et al, 1976).…”

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confidence: 99%

Failure of periodic ultraviolet radiation treatments to prevent sensitization to nitrogen mustard: a case report

et al. 1982

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We have reported that prior ultraviolet radiation (UVR) exposure significantly delayed development of contact sensitivity to nitrogen mustard (Halprin et al., 1981). We felt that this effect was due to disruption of functional Langerhans cells in skin by UVR and suggested that periodic UVR treatments might prevent sensitization to the mustard. We now report on a patient with mycosis fungoides whose epidermal Langerhans cell count was monitored with the ATP-ase stain in order to determine when such 'booster" UVR therapy was to be given. Our attempts to interfere with Langerhans cell function in this manner failed to prevent delayed contact sensitivity to nitrogen mustard and may have been partly responsible for the development of contact urticaria to nitrogen mustard after 28 days of use. Whether the reaction was a delayed, cell-mediated reaction, or an antibody mediated reaction is not clear, but the use of UVR did fail to prevent contact sensitivity to the nitrogen mustard in our patient.

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Topical Use of Mechlorethamine in the Treatment of Psoriasis

Cited by 25 publications

References 4 publications

Long term follow up of topical mustine treatment for cutaneous Langerhans cell histiocytosis

Long term follow up of topical mustine treatment for cutaneous Langerhans cell histiocytosis

Topical Mustine Hydrochloride and Psoriasis

Failure of periodic ultraviolet radiation treatments to prevent sensitization to nitrogen mustard: a case report

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