Topical Nitrogen Mustard

What is nitrogen mustard?

Nitrogen mustard (also known as mechlorethamine or wort) belongs to a class of medications known as alkylating agents. These agents delay or stop the growth of Cancer cells in the body. Nitrogen mustard dust However, the injection is given intravenously to treat certain types of cancer. current Nitrogen mustard formulations can be prepared to treat cutaneous T cell lymphomas, namely mycosis fungoides.

Nitrogen mustard topical preparations are formulated by mixing the injectable powder with water or a ointment base. Water preparation is unstable and should be used immediately, while Nitrogen mustard ointment-based preparations are stable for at least a few months. A 0.016% gel (US trade name Valchlor ™ from Actelion Pharmaceuticals).

How does topical nitrogen mustard work?

Nitrogen mustard belongs to the group of alkylating agents that also include cyclophosphamide, ifosfamide, melphalan, chlorambucil, and carmustine (BiCNU). Nitrogen mustard and carmustine can be used topically to treat lymphomas of the skin. The mechanism of action is still uncertain.

What is Nitrogen Mustard Topical Used for?

Topical nitrogen mustard has been used to treat mycosis fungoides since the 1950s. It is particularly effective in patch or license plate Mycosis fungoides stage. Complete response rates have been achieved in 76-80% of patients with limited patch / plaque (stage IA) and 35-68% in those with generalized patch / plate (stage IB). It is also used for the treatment of Langerhans cell histiocytosis.

How to use nitrogen mustard topical?

There are several different regimes. Nitrogen mustard topical (either a water-based preparation, a gel, or an ointment-based preparation) can be applied daily until the lesions are completely resolved. This can be followed by a time of maintenance therapy for about 1-2 months.

The following general steps should be taken when applying Nitrogen Mustard topical.

• First, apply a small amount of Nitrogen Mustard to a selected (palm-sized) test patch on your skin once a day for 7-10 days. If there is no significant irritation, new eruption, redness or itching you can start applying nitrogen mustard preparation as directed by your doctor to the lesions.
• Nitrogen mustard topical is usually applied once a day after bathing or at night. Apply sparingly to affected areas; Nitrogen mustard is generally absorbed into the skin within the first hour after application.
• Let dry before covering with clothing. Do not wash for 4 hours after application.
• Disposable nitrile gloves can be used to apply the preparation or, alternatively, apply directly with the hands and then wash thoroughly.
• Additional moisturizing lotions or creams can be applied throughout the day as needed.

Precautions when using nitrogen mustard

Do not apply nitrogen mustard to sensitive areas such as the face and genitals. The risk of developing secondary skin cancers is increased in patients who have received multiple skin treatments, such as phototherapy or radiation in addition to topical nitrogen mustard. Nitrogen mustard topical should be used with caution in pregnant or nursing women. It is reported to cause fetal harm.

Be careful not to apply nitrogen mustard topical to the eyes (if this occurs, flush for at least 15 minutes with plenty of water or plain water). saline and seek medical attention). Exposure of others mucous Membranes such as the nostrils, mouth, genitals, and anus should also be avoided.

Nitrogen mustard is a probable carcinogen. This means that it can cause skin cancer. Protect from sun exposure.

Make sure there is no skin contact with another person while applying Nitrogen Mustard topical.

Stop applying topical nitrogen mustard if treated areas become eroded, ulcerated, blistered, or develop severe redness and swelling. When recommending the treatment, apply it less often, for example every 3 days.

Side Effects of Nitrogen Mustard

The most common side effect of nitrogen mustard is a allergic reaction usually itchy, rash, or red (contact dermatitis) Anaphylaxis has been reported but is rare. This is especially a problem in more sensitive areas, such as skin folds, and occurs if solution or ointment preparation is used. In most cases, a reduction in the frequency of application or a decrease in the concentration will decrease the side effects and allow the continuation of the medication. Darkening of the skin may also occur in the area where the nitrogen mustard was applied; This is reversible once the drug is stopped.