The alkylating agent mechlorethamine hydrochloride has been used successfully in the treatment of the mycosis fungoides (MF) form of cutaneous T-cell lymphoma (CTCL) since the 1950s. Despite well-documented clinical experience with mechlorethamine, no topical formulation has been approved by the US Food and Drug Administration. Reliance on compounding pharmacies and the lack of insurance coverage have proven problematic. In this randomized, controlled, multicenter trial, Lessin et al demonstrate the safety and efficacy of a novel mechlorethamine, 0.02%, gel. A manufactured mechlorethamine, 0.02%, gel addresses the unmet needs for good manufacturing product quality assurance that will improve the availability of this drug for patients with MF-CTCL.