Remission of Lesions in Mycosis Fungoides Following Topical Application of Nitrogen Mustard

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METHYL - BIS - (β - CHLOROETHYL) AMINE HYDROCHLORIDE, commonly known as nitrogen mustard, is a nitrogen analogue of sulfur mustard, the vesicant gas of World War I. In 1931, Adair and Bagg reported that the topical and intralesional use of sulfur mustard in the treatment of numerous types of primary and secondary cutaneous malignant lesions gave good initial results, but this therapeutic moiety was subsequently neglected.

Following the development of nitrogen mustard, investigational studies2 into its actions led to the recognition of the similarity of these actions to those of irradiation. Shortly afterwards, nitrogen mustard was used intravenously in the treatment of various forms of lymphoma.3–5 Its use then became extended to the local treatment of malignant effusions in the pleural and peritoneal cavities, and in rheumatoid arthritis6 to the intraarticular cavities.

The purpose of this preliminary report is to present a case of remission in lesions of mycosis fungoides after the local applications of diluted nitrogen mustard solution. To our knowledge this is the first such observation.

Report of a Case

In 1956, a 28-year-old white man was examined by his local physician because of a blotchy nonpruritic axillary eruption. The diagnosis of mycosis fungoides was confirmed by biopsy. Twelve applications of roentgen therapy were given but brought no relief, and the patient was then referred to the Cleveland Clinic.

At the time of our initial examination in February, 1958, the eruption showed discrete, nummular, pea to silver dollar sized erythematous scaling, slightly infiltrated lesions predominantly in. . .



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