Tiffany J. Garcia-Saleem, Connor J. Stonesifer, Alexandra E. Khaleel, Larisa J. Geskin
DOI: 10.2340/00015555-3911

Mycosis fungoides is a type of cutaneous T-cell lymphoma, which accounts for the majority of cases of cutaneous T-cell lymphoma. Mycosis fungoides can be classified as early-stage (IA–IIA) or late-stage (IIB or greater) disease. In early-stage mycosis fungoides, skin-directed therapies are commonly used to manage the disease. Chlormethine, or mechlorethamine, is a topical chemotherapeutic, which has been in use for over 60 years. In 2013, the US Food and Drug Administration approved chlormethine/mechlorethamine gel (Valchlor®) for treatment of stage IA and IB mycosis fungoides. Chlormethine/mechlorethamine gel is an effective therapy; however, its use may be limited by the development of adverse cutaneous reactions. Off-label dosing modifications, as well as co-administration of topical steroids and an aggressive moisturization regimen, can be used to reduce these side-effects. We report here 4 cases of mycosis fungoides treated with chlormethine/mechlorethamine gel at the Comprehensive Skin Cancer Center at Columbia University Irving Medical Center, which provide insights into the use of this therapy in clinical practice.

Mycosis fungoides is a type of cutaneous T-cell lymphoma. In early-stage mycosis fungoides, skin-directed therapies are commonly used to manage the disease. In 2013, the US Food and Drug Administration approved chlormethine/mechlorethamine gel (Valchlor®) for treatment of early-stage mycosis fungoides. Chlormethine/mechlorethamine gel is an effective therapy; however, its use may be limited by development of side-effects. Dosing modifications, co-administration of topical steroids and an aggressive moisturization regimen can be used to reduce these side-effects. We report here 4 cases of mycosis fungoides treated with chlormethine/mechlorethamine gel at Columbia University Irving Medical Center, which provide insights into the use of this therapy in clinical practice.