Minocycline-induced hyperpigmentation

Um Caso de Pigmentação Cutânea e Mucosa Adquirida

“…2 Este caso corresponde ao tipo II caracterizado pela deposição de pigmento em pele previamente sã, não foto exposta, nos antebraços e pernas e relaciona-se com doses cumulativas elevadas. 2,3 No tipo I, o mais frequente, a pigmentação ocorre em lesões inflamatórias na face, nomeadamente em cicatrizes de acne. No tipo III, há uma pigmentação azul-acinzentada difusa em áreas foto--expostas, sobretudo na face.…”

Minocycline-Induced Blue-Gray Discoloration

“…The most common drugs are chemotherapeutic agents, anti-acne antibiotics (tetracycline and minocycline), oral contraceptives, hydroxychloroquine, clofazimine, and amiodarone [1,2,4,5,6,7]. …”

“…Long-term minocycline treatment is prescribed in patients affected by acne/folliculitis, as well as in patients with rheumatic disorders, because of the benefits described in rheumatoid arthritis and osteoarthritis [4,5,6,7]. Numerous studies on the efficacy and safety of minocycline as an antimicrobial drug have been reported, although there are possible side effects after a long-term treatment.…”

“…Nevertheless, this adverse reaction is rarely seen in younger patients affected by acne, but usually in elderly people, with chronic disorders. This is likely the consequence of the cumulative dosage of minocycline, since patients with acne routinely take 50 or 100 mg daily, while the prescription for arthritis is 200 mg daily [5,6,7]. …”

“…However, our patient was affected by type III, showing hyperpigmentation of the sun-exposed areas, characterized by nonspecific melanin deposition in the basal layer at histological staining. This type is more resistant to treatment and persists indefinitely, especially in patients undergoing a long-term treatment [5,6,7]. …”