A new type of minocycline-induced cutaneous hyperpigmentation

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dc.contributor.authorMouton R.W.
dc.contributor.authorJordaan H.F.
dc.contributor.authorSchneider J.W.
dc.date.accessioned2011-05-15T16:16:04Z
dc.date.available2011-05-15T16:16:04Z
dc.date.issued2004
dc.description.abstractPigmentary disorders are recognized adverse effects of the semi-synthetic tetracycline derivative antibiotic, minocycline. Three distinct types of minocycline-induced cutaneous pigmentation have been described. Type I, blue-black pigmentation confined to sites of scarring or inflammation on the face: Type II, blue-grey circumscribed pigmentation of normal skin of the lower legs and forearms; and Type III, diffuse muddy brown pigmentation of normal skin accentuated in sun-exposed areas. We report two patients with acne vulgaris with a fourth type of minocycline-induced cutaneous pigmentation. They presented with circumscribed blue-grey pigmentation within acne scars confined to the back. Histology showed pigment within dendritic cells, and extracellularly throughout the dermis. Histochemistry identified a calcium containing melanin-like substance. Iron was absent. Immunohistochemistry confirmed some pigment-containing cells to be macrophages. Electron microscopy demonstrated electron-dense granules, free and membrane-bound, within macrophages and fibroblast-like cells. Energy-dispersive X-ray analysis confirmed the presence of calcium. Iron was absent. This fourth type of cutaneous minocycline hyperpigmentation may be a variant of Type I, but based on clinical, pathological and microanalytical differences, appears to be a new entity. The pigment may be a drug metabolite-protein complex chelated with calcium, or an insoluble minocycline-melanin complex. We propose a classification of cutaneous minocycline pigmentation based on clinico-pathological criteria.
dc.description.versionArticle
dc.identifier.citationClinical and Experimental Dermatology
dc.identifier.citation29
dc.identifier.citation1
dc.identifier.issn03076938
dc.identifier.other10.1111/j.1365-2230.2004.01421.x
dc.identifier.urihttp://hdl.handle.net/10019.1/13618
dc.subjectcalcium
dc.subjectdrug metabolite
dc.subjectiron
dc.subjectmelanin
dc.subjectminocycline
dc.subjectacne vulgaris
dc.subjectadult
dc.subjectarticle
dc.subjectcase report
dc.subjectcell membrane
dc.subjectchelation
dc.subjectclinical feature
dc.subjectdendritic cell
dc.subjectdermis
dc.subjectdisease classification
dc.subjectdrug induced disease
dc.subjectelectron
dc.subjectelectron microscopy
dc.subjectenergy
dc.subjectfibroblast
dc.subjectfollow up
dc.subjecthistochemistry
dc.subjecthuman
dc.subjecthyperpigmentation
dc.subjectimmunohistochemistry
dc.subjectmacrophage
dc.subjectmale
dc.subjectmouth mucosa
dc.subjectpatient
dc.subjectpriority journal
dc.subjectscar formation
dc.subjectskin biopsy
dc.subjectskin pigmentation
dc.subjectsolubility
dc.subjectX ray analysis
dc.subjectAcne Vulgaris
dc.subjectAdult
dc.subjectAnti-Bacterial Agents
dc.subjectBiopsy
dc.subjectHumans
dc.subjectHyperpigmentation
dc.subjectMale
dc.subjectMinocycline
dc.subjectSkin
dc.titleA new type of minocycline-induced cutaneous hyperpigmentation
dc.typeArticle
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