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

Quatrebarbes, Julie De; Estève, É.; Bagot, Martine; Bernard, Philippe; Beylot‐Barry, M.; Delaunay, M.; D’Incan, M.; Souteyrand, P; Vaillant, L.; Cordel, N.; Courville, Philippe; Joly, P.

doi:10.1001/archderm.141.9.1117

Cited by 51 publications

(37 citation statements)

References 27 publications

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confidence: 99%

“…The BFA mechlorethamine (2-chloro-N-(2-chloroethyl)-N-methyl-ethanamine, nitrogen mustard, NM) is a topical chemotherapeutic agent typically used to treat cutaneous T-cell lymphomas (de Quatrebarbes et al, 2005). A regimen involves topical application of a 0.02% solution (ϳ1 mM) (de Quatrebarbes et al, 2005). Occupational exposure to the BFA bis-(2-chloroethyl) sulfide (sulfur mustard, SM) (Davis and Aspera, 2001) has been a concern because SM has known mutagenic properties and can cause significant skin blistering (Papirmeister et al, 1991).…”

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confidence: 99%

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Bifunctional Alkylating Agent-Induced p53 and Nonclassical Nuclear Factor κB Responses and Cell Death Are Altered by Caffeic Acid Phenethyl Ester: A Potential Role for Antioxidant/Electrophilic Response-Element Signaling

Minsavage

Dillman²

2007

J Pharmacol Exp Ther

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Bifunctional alkylating agents (BFA) such as mechlorethamine (nitrogen mustard) and bis-(2-chloroethyl) sulfide (sulfur mustard; SM) covalently modify DNA and protein. The roles of nuclear factor B (NF-B) and p53, transcription factors involved in inflammatory and cell death signaling, were examined in normal human epidermal keratinocytes (NHEK) and immortalized HaCaT keratinocytes, a p53-mutated cell line, to delineate molecular mechanisms of action of BFA. NHEK and Ha-

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confidence: 99%

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confidence: 99%

Bifunctional Alkylating Agent-Induced p53 and Nonclassical Nuclear Factor κB Responses and Cell Death Are Altered by Caffeic Acid Phenethyl Ester: A Potential Role for Antioxidant/Electrophilic Response-Element Signaling

Minsavage

Dillman²

2007

J Pharmacol Exp Ther

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“…Mild irritant dermatitis, including pruritus, dysesthesias, and eczematous reactions, are the most common. 30,41 Hyperpigmentation has also been reported in a large number of patients and is reversible after drug cessation. 30,42 One rare case report documented anaphylaxis after application.…”

Section: Skin-directed Therapies In Ctclmentioning

confidence: 99%

“…43 The most common cause of therapy cessation is a delayed allergic contact dermatitis that can range from mild erythema to bullae formation. 29,[34][35][36]38,41 Irritant and allergic contact dermatitis have been reported in up to 80% of patients treated with the aqueous formulation, 29% with ointment, and 40% with the gel. 30,37 However, therapy discontinuation can usually be prevented by application of topical steroids, prior desensitization in the case of an allergic contact dermatitis, or decreasing the concentration of the medication or frequency of application in cases of irritant dermatitis.…”

Section: Skin-directed Therapies In Ctclmentioning

confidence: 99%

“…31,42,44 A 2005 French study of 64 stage T1 and T2 patients with MF, revealed that combination treatment with topical nitrogen mustard and topical steroids could reduce adverse cutaneous reactions and still be effective. 41 Patients were treated with twice-weekly 0.02% mechlorethamine aqueous solution to the entire skin surface, excluding the head. Within 10 minutes of application of nitrogen mustard, up to 15 g of betamethasone cream was applied.…”

Section: Skin-directed Therapies In Ctclmentioning

confidence: 99%

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Skin-Directed Therapies in Cutaneous T-Cell Lymphoma

Nguyen

Bohjanen

2015

Dermatologic Clinics

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Early stage mycosis fungoides represents the most common clinical presentation of cutaneous lymphoma, with skin-directed therapies long established in its treatment. These therapies continue to change as new treatment regimens emerge. Other skin-directed treatments include light and radiation therapy. Therapies with higher levels of evidence and less systemic toxicity are usually preferred as first-line treatment. However, even these established therapies, like topical corticosteroids and carmustine, lack randomized clinical trials to establish their efficacy. Research is also needed to further define the role of combination topical therapies and how skin-directed therapies can be used as adjuvants to systemic medications.

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Surgical Treatment of Persistent Macrocheilia in Patients With Melkersson-Rosenthal Syndrome and Cheilitis Granulomatosa

Kruse‐Lösler

Presser²,

Metze³

et al. 2005

Arch Dermatol

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Background: Various conservative methods for treatment of labial swelling in patients with cheilitis granulomatosa have been attempted, often with only moderate success and sometimes with persistent disfiguring lip swelling. Severe macrocheilia can produce an unaesthetic facial deformity associated with functional disturbances. In patients with persistent macrocheilia, reduction cheiloplasty with excision of excess tissue may be indicated when conservative treatment has proven ineffective in reducing swelling but may have been successful in stabilizing disease.Objective: To evaluate long-term results after reduction cheiloplasty in patients with macrocheilia caused by Melkersson-Rosenthal syndrome or cheilitis granulomatosa.Design: Follow-up study in 7 patients with severe persisting macrocheilia, including 3 patients with Melkersson-Rosenthal syndrome and 4 patients with cheilitis granulomatosa in a stable state of disease, treated by reduction cheiloplasty at our hospital between January 1, 1987, and December 31, 2002. Preoperative and postoperative medical histories were obtained, and criteria for the success of surgical treatment were evaluated by clinical examination. Different techniques of reduction cheiloplasty are described and demonstrated in representative cases of severe macrocheilia.Results: Surgical treatment in all 7 patients showed satisfying aesthetic and functional outcomes that persisted throughout follow-up (median follow-up, 6.5 years).Conclusions: Reduction cheiloplasty is an effective method to correct persistent macrocheilia and improve lip aesthetics in patients with Melkersson-Rosenthal syndrome or granulomatous cheilitis in the persistent state of disease. With careful planning, proper sequencing of treatment, and proficiency in the various surgical techniques, optimal results can be achieved.

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

Cited by 51 publications

References 27 publications

Bifunctional Alkylating Agent-Induced p53 and Nonclassical Nuclear Factor κB Responses and Cell Death Are Altered by Caffeic Acid Phenethyl Ester: A Potential Role for Antioxidant/Electrophilic Response-Element Signaling

Bifunctional Alkylating Agent-Induced p53 and Nonclassical Nuclear Factor κB Responses and Cell Death Are Altered by Caffeic Acid Phenethyl Ester: A Potential Role for Antioxidant/Electrophilic Response-Element Signaling

Skin-Directed Therapies in Cutaneous T-Cell Lymphoma

Surgical Treatment of Persistent Macrocheilia in Patients With Melkersson-Rosenthal Syndrome and Cheilitis Granulomatosa

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