What should you know about topical nitrogen mustard therapy for mycosis fungoides?

Mycosis fungoides is a type of cutaneous T-cell lymphoma that can appear on the skin as patches or plaques. Topical nitrogen mustard, also called mechlorethamine in some products, is applied to involved areas to act locally. A specialist chooses it according to the skin findings, extent of disease, treatment history, and practical ability to apply it safely. It is not a general-purpose cream for undiagnosed rashes.

Follow the prescribed amount and schedule, use the recommended gloves or applicator, and wash hands after application. Avoid contact with eyes, mouth, nose, genital skin, and unaffected skin unless your treatment team gives different instructions. Store it exactly as directed and keep it away from children and other household members. Do not alter the routine when a patch improves without discussing the change.

Contact the treatment team for severe burning, blistering, open sores, spreading redness, signs of infection, or a rash beyond the treated areas. Seek urgent help for eye exposure, breathing difficulty, or facial swelling. Report new lumps, persistent enlarged nodes, fever, or rapidly changing skin findings because the disease may need reassessment.

Ask which areas to treat, how to protect household contacts, what irritation is expected, and when the skin should be reviewed. Discuss alternatives such as narrowband UVB phototherapy, PUVA therapy, or topical corticosteroids, and ask how your specialist will judge whether the plan is working.