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Folliculotropic mycosis fungoides (MF) is a rare variant of cutaneous T-cell lymphoma with distinct clinical and histological features that is less responsive to therapy than the classic epidermotropic subtype of MF (1, 2). At any given stage, the folliculotropic variant has a worse prognosis than the epidermotropic variant. Due to the (peri) follicular nature of the neoplastic cells in folliculotropic MF, the T-cell infiltrate is thought to be too deep for penetration of many skin-directed treatments. Topical monotherapy is not currently recommended in the current National Comprehensive Cancer Network (NCCN) (3) guidelines as a mainstay treatment option even in patients with a low burden of disease. There is limited evidence that carmustine topical therapy (also known as bis-chlorethylnitrosourea or BCNU) may be beneficial in the treatment of folliculotropic MF. In this study, we hypothesized that topical carmustine would be a safe and effective treatment option for patients with stages I–III folliculotropic MF.

Topical Carmustine as Monotherapy or as Multimodality Therapy for Folliculotropic Mycosis Fungoides