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February 1982

Topical Mechlorethamine Therapy for Mycosis Fungoides: Proposed Schedule to Overcome Drug Resistance

Author Affiliations

From the Department of Dermatology, University Hospital, Tromsø, Norway (Dr Volden); Department of Dermatology, University Hospital, Linköping, Sweden (Dr Molin); Department of Dermatology, Finsen Institute, Copenhagen (Dr Thomsen).

Arch Dermatol. 1982;118(2):138-139. doi:10.1001/archderm.1982.01650140070028

Topical whole-body application of mechlorethamine hydrochloride has been shown to be efficacious in the treatment of mycosis fungoides (MF) confined to the skin.1,2 The infiltrated plaques and tumors considerably resolve by supplementary soaks with mechlorethamine.3

The main side effect of topical mechlorethamine is the development of an allergic contact dermatitis. This problem may be overcome by percutaneous hyposensitization, but this is a protracted and not always successful procedure.3,4 A more effective approach might be to treat the patient with psoralen and ultraviolet A (PUVA) for a few months, after which the contact sensitivity to mechlorethamine seems to be suppressed.5 Another problem related to the application of topical mechlorethamine, as described by Vonderheid et al,6 is that drug resistance was the basis for recurrent disease in about 20% of patients with early MF despite maintenance with mechlorethamine therapy.

Currently, the usual procedure in treating MF with

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