To the Editor.—
Seven patients with long-standing alopecia totalis (duration >5 years) had not responded to therapies including topical steroids, intralesional steroids, and topical dinitrochlorobenzine plus diphencyprone. Because of a lymphocytic effect of nitrogen mustard1 and the involvement of lymphocytes in the pathogenesis of alopecia areata,2 we investigated the effect of topical nitrogen mustard applied to the scalp. The lotion was applied topically to the scalp for 1 month, and during therapy there were no local reactions, the treatment being well tolerated by all patients. These cases were reviewed after therapy, but at no time was there any sign of hair regrowth.The present study suggests that topical nitrogen mustard has no benefit in widespread alopecia areata.
Harrison PV, Latona J, Jovanovic M. Alopecia Totalis and Topical Mustine. Arch Dermatol. 1993;129(4):514. doi:10.1001/archderm.1993.01680250130027