Topical carmustine therapy for lymphomatoid papulosis

Seven patients with lymphomatoid papulosis were treated with solutions of topical carmustine, a nitrosourea compound. Recently used schedules have employed 10 mg of carmustine in dilute alcohol applied to the total skin surface daily for four to 17 weeks (total dosage, 280 to 1,180 mg). All patients experienced a rapid reduction in the number and size of lesions. Maintenance therapy consisted of local applications of carmustine (2 to 4 mg/mL of 95% ethanol) to individual new papules. This method was effective in suppressing disease activity and reduced by half the average life cycle of individual lesions. However, long-term lesion-free remissions were not seen. Bone marrow depression did not occur.