Document Detail


Minocycline-induced hyperpigmentation in patients with pemphigus and pemphigoid.
MedLine Citation:
PMID:  10987869     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Immunosuppressive medications typically used to treat the immunobullous disorders pemphigus vulgaris, pemphigus foliaceous, and bullous pemphigoid can have serious adverse effects. The tetracycline family of antibiotic drugs has been shown to be effective in the treatment of these conditions with a more favorable side effect profile. Minocycline hydrochloride use has been associated with various forms of hyperpigmentation, and its incidence is well reported in acne vulgaris and rheumatoid arthritis. We examined a series of 9 patients treated with minocycline for pemphigus or pemphigoid, most of whom have developed cutaneous hyperpigmentation. OBSERVATIONS: Seven of 9 patients treated with minocycline, 50 mg daily (1 patient) or 100 mg twice daily (8 patients), for pemphigus vulgaris, pemphigus foliaceous, or bullous pemphigoid developed hyperpigmentation, which necessitated discontinuing therapy. Five of these patients had experienced notable clinical improvement of their immunobullous disease with minocycline therapy. The average duration of treatment was 8.2 months (range, 1-25 months). The second most common adverse effect in our group was oral candidiasis, which occurred in 2 patients. CONCLUSIONS: We found a favorable response to minocycline therapy in 5 of 9 patients. However, 7 patients developed localized hyperpigmentation as early as 1 month after starting medication use. This incidence of minocycline-induced hyperpigmentation is significantly higher in immunobullous disease than in acne vulgaris or rheumatoid arthritis. This increased incidence may be related to an increase in pigment deposition complexed with collagen during the remodeling process, subclinical inflammation, or glucocorticosteroid-induced skin fragility. The hyperpigmentation process was reversible, as most of our patients had fading of their pigmentation after minocycline cessation.
Authors:
D M Ozog; D S Gogstetter; G Scott; A A Gaspari
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Archives of dermatology     Volume:  136     ISSN:  0003-987X     ISO Abbreviation:  Arch Dermatol     Publication Date:  2000 Sep 
Date Detail:
Created Date:  2000-10-03     Completed Date:  2000-10-03     Revised Date:  2008-03-17    
Medline Journal Info:
Nlm Unique ID:  0372433     Medline TA:  Arch Dermatol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1133-8     Citation Subset:  AIM; IM    
Affiliation:
Departments of Dermatology, Microbiology/Immunology, and the Cancer Center, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anti-Bacterial Agents / administration & dosage,  adverse effects*
Dose-Response Relationship, Drug
Drug Administration Schedule
Female
Humans
Hyperpigmentation / chemically induced*,  diagnosis,  pathology
Male
Middle Aged
Minocycline / administration & dosage,  adverse effects*
Pemphigoid, Bullous / drug therapy*,  pathology
Pemphigus / drug therapy*,  pathology
Skin / drug effects,  pathology
Grant Support
ID/Acronym/Agency:
1R01-AH/OH4108-01/AH/BHP HRSA HHS
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 10118-90-8/Minocycline

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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