A 68-year-old woman developed an urticarial and anaphylactoid reaction after total body surface application of mechlorethamine hydrochloride. Application of mechlorethamine to a test area produced a wheal and flare response and confirmed the diagnosis. This patient previously used this chemical intermittently over a five-year period without allergic manifestations. To our knowledge, this is the first documented anaphylactoid reaction to topical application of mechlorethamine. This report alerts physicians using mechlorethamine and other medicaments topically to the always potentially fatal complication of anaphylaxis.
Daughters D, Zackheim H, Maibach H. Urticaria and Anaphylactoid ReactionsAfter Topical Application of Mechlorethamine. Arch Dermatol. 1973;107(3):429-430. doi:10.1001/archderm.1973.01620180079025