Alkylating agents have been used for many years for their antineoplastic and immunosuppressive properties. In recent years, alkylating agents have found utility in various nononcology applications, particularly in the treatment of autoimmune diseases, due to their ability to suppress humoral and cell-mediated immunity. Dermatologic applications of alkylating agents have also been increasing. This article presents the basic pharmacologic properties of the two most commonly used alkylating agents in dermatology, cyclophosphamide and chlorambucil. Recent applications of these two agents in the treatment of autoimmune blistering diseases are also reviewed.
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