Journal
DERMATOLOGY AND THERAPY
Volume 12, Issue 3, Pages 643-654Publisher
ADIS INT LTD
DOI: 10.1007/s13555-022-00681-6
Keywords
Contact dermatitis; Drug reactions; Lymphoma; MF; Patch testing; Prescription drug management; Therapeutics
Categories
Funding
- Helsinn
- Rochester General Hospital Skin Disease Research Fund
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This study aimed to evaluate the effectiveness of 0.1% triamcinolone ointment in reducing contact dermatitis associated with the use of mechlorethamine/chlormethine gel for the treatment of MF. The results showed that triamcinolone ointment increased the tolerability of mechlorethamine/chlormethine gel without affecting its efficacy.
Introduction Treatment of early-stage mycosis fungoides (MF) requires safe, skin-directed therapies. Medication side effects can lead to underutilization of effective therapies. The objective of this study was to assess the use of topical triamcinolone 0.1% ointment as a means of reducing contact dermatitis associated with topical mechlorethamine/chlormethine gel for the treatment of MF. Methods This prospective, randomized, open-label study evaluated 28 adults with mycosis fungoides who were eligible for treatment with topical mechlorethamine/chlormethine gel from December 17, 2017 to December 23, 2020. Patients were treated for 4 months with clinical follow-up through 12 months. Patients had half of their lesions also treated with topical triamcinolone 0.1% ointment (while the other half were treated with mechlorethamine/chlormethine alone). The study was self-controlled with separate lesions in the same patient receiving each treatment arm. Treatment arms were determined by the flip of a coin. Results Twenty-eight patients enrolled (17 men (61%) and 11 women (39%)). Demographics included 25 White, 2 African Americans, and 1 Asian patient. Twenty-five completed the 12-month follow-up. Triamcinolone 0.1% ointment led to increased tolerability of mechlorethamine/chlormethine gel but did not change the efficacy of mechlorethamine/chlormethine. There was a statistically significant 50% decrease in dermatitis (SCORD score) at month 2 in the triamcinolone-treated arm. Conclusions Topical triamcinolone ointment is a helpful adjuvant therapy when treating patients with topical mechlorethamine/chlormethine gel. It diminishes inflammation and does not reduce efficacy. The peak incidence of dermatitis in the study occurred in the second and third months.
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