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This activity has been sponsored by Helsinn Healthcare SA and Recordati Rare Diseases. Helsinn Healthcare SA provided financial support and has had input into the selection of the faculty and the detailed project scope. This activity is provided by Touch Medical Communications (TMC) for touchONCOLOGY.

Dermatological Cancer Watch Time: 28 mins

touchSYMPOSIUM HIGHLIGHTS Dermatitis management and chlormethine gel: new key learning points

Watch this symposium discussing contact dermatitis management in MF-CTCL. Filmed during the 4th World Congress of Cutaneous Lymphomas on February 12, 2020 in Barcelona, Spain.

Watch the symposium presentation from Dr Brian Poligone Watch Now

  • Symposium Presentations
Introducing chlormethine gel
MIDAS (Mechlorethamine Induced Contact Dermatitis Avoidance Study)
Presenting clinical cases with chlormethine gel
About Dr Brian Poligone

Dr Poligone is the Medical Director at the Rochester Skin Lymphoma Medical Group in Fairport, NY, USA.


Honoraria from Kyowa, Mallinckrodt, Regeneron, Stemline. Research funding from Astex, Bioniz, Helsinn, Innate Pharmaceuticals, Kyowa, Miragen, Soligenix. Consultant for Helsinn, Regeneron, Stemline

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Overview & Learning Objectives

Mycosis fungoides (MF) is one of the most common types of cutaneous T-cell lymphoma (CTCL). Topical chlormethine gel has been specifically developed for the treatment of MF and is recommended by EORTC guidelines as one of several first-line therapies for adults with MF. Contact dermatitis is a common side effect of chlormethine gel. Some patients benefit from the addition of triamcinolone to chlormethine gel in order to reduce dermatitis.

This presentation includes four case reports illustrating the need to tailor treatment to the patient. These demonstrate that mild-to-moderate dermatitis may not require treatment suspension but may require emollients, topical steroids or decreased dosing frequency. Severe dermatitis requires treatment suspension or discontinuation. Although some patients may be unable to tolerate the therapy as typically prescribed, partial responses and complete responses are possible in patients with dermatitis reactions.

Learning Objectives

After watching this activity participants should be better able to:

  • Understand current US clinical practice in the management of MF-CTCL
  • Understand the optimal use of chlormethine gel in this treatment setting
  • Manage contact dermatitis in MF-CTCL patients treated with chlormethine gel
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  1. Scarisbrick J. Staging of mycosis fungoides and Sézary syndrome: time for an update? EMJ Allergy Immunol. 2018;6:92–100.
  2. Wilcox RA, Cutaneous T-cell lymphoma: 2016 update on diagnosis, risk-stratification, and management. Am J Hematol. 2016;91:151–65.
  3. Vij A, Duvic M, Prevalence and severity of pruritus in cutaneous T cell lymphoma. Int J Dermatol. 2012;51:930–4.
  4. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology (NCCN Guidelines®) non-small cell lung cancer version 3. 2019. Available at: www.nccnorg/professionals/physician_gls/pdf/nsclpdf (accessed 11 February 2019).
  5. Ramsay DL, Parnes RE, Dubin N. Response of mycosis fungoides to topical chemotherapy with mechlorethamine. Arch Dermatol. 1984;120:1585–90.
  6. Vonderheid EC, Tan ET, Kantor AF, et al. Long-term efficacy, curative potential, and carcinogenicity of topical mechlorethamine chemotherapy in cutaneous T cell lymphoma. J Am Acad Dermatol. 1989;20:416–28.
  7. Kim YH, Martinez G, Varghese A, et al. Topical nitrogen mustard in the management of mycosis fungoides: update of the Stanford experience. Arch Dermatol. 2003;139:165–73.
  8. Lessin SR, Duvic M, Guitart J, et al. Topical chemotherapy in cutaneous T-cell lymphoma: positive results of a randomized, controlled, multicenter trial testing the efficacy and safety of a novel mechlorethamine, 0.02%, gel in mycosis fungoides. JAMA Dermatol. 2013;149:25–32.
  9. Esteve E, Bagot M, Joly P, et al. A prospective study of cutaneous intolerance to topical mechlorethamine therapy in patients with cutaneous T-cell lymphomas. French Study Group of Cutaneous Lymphomas. Arch Dermatol. 1999;135:1349–53.
  10. Gilmore E, Franklin J. Mechlorethamine-induced contact dermatitis avoidance study (MIDAS): preliminary results. Presented at: The 49th European Society for Dermatological Research Annual Meeting; Bordeaux, Southern France, 18–21 September 2019. Poster 60.
  11. European Task Force on Atopic Dermatitis. Severity scoring of atopic dermatitis: the SCORAD index. Consensus Report of the European Task Force on Atopic Dermatitis. Dermatology. 1993;186:23–31.

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