Cyclophosphamide is an alkylating agent, primarily synthesized as a derivative of nitrogen mustard. Currently, it is approved by the FDA for advanced mycoses fungoides. Other uses of cyclophosphamide in dermatology are off-label. Cyclophosphamide is of particular importance in the management of pemphigus. Other indications where cyclophosphamide is employed include vasculitis, connective tissue disorders, Langerhans cell histiocytosis, scleromyxedema and neutrophilic dermatoses, to name a few.