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Minocycline-induced hyperpigmentation in multibacillary leprosy.
MedLine Citation:
PMID:  23169418     Owner:  NLM     Status:  In-Data-Review    
ABSTRACT:: Minocycline has been used in the treatment of leprosy since the demonstration of its efficacy in inhibiting Mycobacterium leprae growth in 1987. Hyperpigmentation, a well-documented adverse effect, classically shows 3 clinical and histological patterns: type I consists of blue-black pigmentation in areas of current or previous inflammation, type II consists of blue-gray pigmentation of normal skin, often seen on the legs, and type III consists of diffuse muddy-brown pigmentation accentuated on sun-exposed sites. Whereas type I hyperpigmentation stains positively for hemosiderin and type III hyperpigmentation stains positively for melanin, type II hyperpigmentation stains positively for both. We describe 2 patients with leprosy on minocycline therapy who developed multiple patches of blue-gray pigmentation within preexisting leprosy lesions. Biopsies from both patients demonstrated deposition of brownish-black pigment granules within the cytoplasm of foamy histiocytes that was highlighted by both Perls and Fontana-Masson stains. Given the clinical and histological findings in our patients, it is as yet unclear whether this coexistent type I clinical pattern and type II histopathologic pattern of pigmentation is unique to multibacillary leprosy. These findings provide support for the existence of additional subtypes of minocycline-induced hyperpigmentation that do not adhere to the classic 3-type model described.
Stephanie W Hu; Maria R Robinson; Tracey Newlove; Shane Meehan; William R Levis; Rishi R Patel
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American Journal of dermatopathology     Volume:  34     ISSN:  1533-0311     ISO Abbreviation:  Am J Dermatopathol     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7911005     Medline TA:  Am J Dermatopathol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e114-8     Citation Subset:  IM    
*Department of Dermatology, New York University, New York, NY †Department of Dermatology, New York University Section of Dermatopathology, New York University, New York, NY.
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