Adverse Reactions Induced by Minocycline: A Review of Literature

Dominic, Maria Rose

doi:10.2174/15748863mtezsndqe3

Cited by 3 publications

(5 citation statements)

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“…Minocycline is a tetracycline-class antibiotic that is often considered first-line treatment since it has been found to completely clear skin eruptions; however, recurrence in the subsequent months following cessation of therapy is common [ 1 ]. Minocycline-associated toxicities, compared to other tetracycline-class antibiotics, include drug hypersensitivity, drug-induced lupus/vasculitis/hepatitis, blue-gray skin hyperpigmentation, acute eosinophilic pneumonia, pseudotumor cerebri, and vestibular instability [ 3 ]. While the absolute risk is comparatively low, there is an 8.5-fold increased risk of minocycline-induced lupus [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…Conversely, doxycycline-an equally long-acting tetracycline antibiotic-has arguably a more favorable side efect profle including GI upset and photosensitivity. Doxycycline 100 mg twice daily for 3 months has been an efective alternative in treating CARP, but its use remains limited as the second-line treatment in isolated cases [3]. Response rates in the literature have been variable, with one retrospective study in southern India suggesting a less robust response to doxycycline compared to minocycline [5].…”

Section: Discussionmentioning

confidence: 99%

“…Characteristic lesions present as scaly, brown macules and papules that coalesce into reticulated patches and plaques on the neck, back, and flexural surfaces [ 2 ]. Minocycline has historically been considered the treatment of choice for CARP; however, given its side effect profile, including but not limited to hyperpigmentation, drug-induced hypersensitivity syndrome, drug-induced lupus, dyspigmentation, and vestibular dysfunction, alternative therapies with a more favorable side effect profile, such as doxycycline, may be worth considering [ 3 ]. While there have been reports of successful responses to doxycycline, it is still not considered a first-line agent for CARP.…”

Section: Introductionmentioning

confidence: 99%

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A Case for Doxycycline as an Effective Treatment for Confluent and Reticulated Papillomatosis (CARP)

Sharma

Moon

Kim

2023

Case Reports in Dermatological Medicine

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Confluent and reticulated papillomatosis (CARP) is a rare keratinization disorder that presents with asymptomatic, reticulated papules coalescing into plaques, which adversely affect, most often, young black persons. Minocycline is considered the drug of choice, but it is not without its host of potential side effects, including drug hypersensitivity, drug-induced lupus/vasculitis/hepatitis, blue-gray skin hyperpigmentation, acute eosinophilic pneumonia, pseudotumor cerebri, and vestibular instability, among others. Alternatively, doxycycline might be considered as another first-line agent for CARP as it can effectively clear lesions while offering a more favorable side effect profile in select patients. Herein, we present a case of CARP successfully resolved with doxycycline after a protracted treatment history of topical and oral antifungal medications for suspected tinea versicolor (TV).

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Case for Doxycycline as an Effective Treatment for Confluent and Reticulated Papillomatosis (CARP)

Sharma

Moon

Kim

2023

Case Reports in Dermatological Medicine

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“…Minocycline or its metabolites may lead to antigen specific T‐cell mediated inflammation cascade, leading to immune complex deposition in the cutaneous tissue, and tissue inflammation secondary to neutrophil and macrophage activation 6 . This may result in numerous autoimmune syndromes such as polyarteritis nodosa, autoimmune hepatitis and drug‐induced lupus, 8 drug rash with eosinophilia and systemic symptoms (DRESS) syndrome, dermatomyositis, sweets syndrome, serum sickness‐like reaction, Stevens‐Johnson syndrome, toxic epidermal necrolysis and acute generalized exanthematous pustulosis 6,8,9 . Some autoimmune‐related effects of minocycline may lead to positive ANA ± ANCA positive vasculitis 7,10 .…”

Section: Main Textmentioning

confidence: 99%

Nodular vasculitis (erythema induratum) associated with systemic minocycline

Farrugia,

Cachia,

Betts

et al. 2023

Aust J Dermatology

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A 29‐year‐old Caucasian woman presented with a 3‐month history of bilateral lower limb swelling with painful erythematous nodules on shins without ulceration. She had been taking minocycline for acne vulgaris for 3 years. Biochemical investigations showed deranged liver function test with positive ANA and mixed antinuclear factor (ANF) pattern. A skin biopsy was in keeping with a diagnosis of nodular vasculitis. Her skin lesions and liver function test improved within 3 months of stopping the minocycline treatment. This case report raises the awareness that minocycline could be a potential cause of nodular vasculitis, patients on minocycline should be closely monitored and minocycline should ideally not be prescribed for more than 12 weeks, given the possible adverse effects.

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“…Serologic findings for hepatitis B and C and HIV were not detected. Minocycline‐induced vasculitis was diagnosed (1,2). Lesions healed with cessation of minocycline, a course of oral glucocorticoids, and local wound care.…”

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confidence: 99%

Clinical Images: Minocycline‐induced vasculitis

Ocon

Duffy

2022

ACR Open Rheumatology

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The patient, a 60-year-old male with facial rosacea who was prescribed minocycline for more than 20 years, presented to outpatient rheumatology and dermatology practices with progressive gray hyperpigmentation and necrotic ulcerative lesions on his bilateral lower extremities (A) and toes (B and C). He also noted black hyperpigmentation in his oral gingiva and buccal mucosa. Additionally, he developed progressive numbness and neuropathic pain in the lower extremities. Serologically, he was negative for antinuclear antibody, antineutrophil cytoplasmic antibodies (including myeloperoxidase and proteinase-3 antibodies), rheumatoid factor, anti-cyclic citrullinated peptide antibodies, cryoglobulin, and anti-SSA (Ro) and anti-SSB (La) antibodies. His serum creatine kinase level and urinalysis result were normal. Serum protein electrophoresis did not detect a paraprotein. Serologic findings for hepatitis B and C and HIV were not detected. Minocycline-induced vasculitis was diagnosed (1,2). Lesions healed with cessation of minocycline, a course of oral glucocorticoids, and local wound care. Hyperpigmentation decreased. Neuropathic pain symptoms also improved. Recognition of drug-induced vasculitis is essential in patients with pigmentation changes, cutaneous ulcerations, and neuropathy (3,4). Case series of minocycline-induced vasculitis reactions, including polyarteritis nodosa-like vasculitis, have been reported (5).

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Adverse Reactions Induced by Minocycline: A Review of Literature

Cited by 3 publications

References 0 publications

A Case for Doxycycline as an Effective Treatment for Confluent and Reticulated Papillomatosis (CARP)

A Case for Doxycycline as an Effective Treatment for Confluent and Reticulated Papillomatosis (CARP)

Nodular vasculitis (erythema induratum) associated with systemic minocycline

Clinical Images: Minocycline‐induced vasculitis

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