Black breast milk due to minocycline therapy

Hunt, Michelle J; SALSBURY, E.L.C.; Grace, Julienne; Armati, R. P.

doi:10.1111/j.1365-2133.1996.tb06332.x

Cited by 30 publications

(12 citation statements)

References 9 publications

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“…These findings have been reproduced in human case reports. Glandular deposition of iron-bound pigment may be responsible for several cases of black galactorrhea in women [28,29]. It is unclear if similar deposits cause discoloration of connective and cardiac valvular tissues [30].…”

Section: Are There Other Manifestations Of Minocycline Discoloration?mentioning

confidence: 99%

Minocycline Toxicity: Case Files of the University of Massachusetts Medical Toxicology Fellowship

2012

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A 61-year-old man was brought to the emergency department (ED) for shortness of breath, fatigue, frequent falls, and bluish discoloration of his skin. The primary care physician transferred the patient due to concern for cyanosis. On presentation to the ED, the patient was oriented but appeared fatigued. The patient was afebrile and had the following vital signs: blood pressure 161/88 mmHg, pulse 71/min, respiratory rate 16/min, and oxygen saturation 100 % on room air by fingertip pulse oximetry. On physical exam, pupils were 4 mm and reactive bilaterally, extraocular movements were intact, and there was no nystagmus. Anicteric sclerae were notable for blue pigmentation (Fig. 1). Heart sounds were regular, without murmurs, rubs, or gallops. Lung sounds were clear to auscultation bilaterally. Other than ataxia, the neurological exam was unremarkable. The skin had a generalized bluish tinge, especially on the arms, with darker pigmentation on the cheeks (Figs. 2, 3 and 4). There was acne on the back and facial rosacea. Bluish discoloration was also noted under the proximal nail beds (Fig. 5). When questioned about the skin discoloration, the patient and his family members described an insidious onset. Photographs of the patient from years ago confirmed that this was not congenital. Medical history included acne, orthostatic hypotension, and Parkinson's disease, for which a deep brain stimulator had been surgically implanted. A comprehensive medication list was not immediately available; however, the patient denied any recent medication additions or adjustments. The patient was unemployed, denied any recent travel, and no other members of his household were complaining of fatigue or similar blue skin discoloration.

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Section: Are There Other Manifestations Of Minocycline Discoloration?mentioning

confidence: 99%

Minocycline Toxicity: Case Files of the University of Massachusetts Medical Toxicology Fellowship

2012

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“…5,6,14 In one study of 700 adult patients, pigmentation only occurred after a minimum of eight months and with a cumulative dose exceeding 70 g. 5 The prevalence was 0.4 per cent at a dose of 100 mg/day and 4 per cent at 200 mg/day, 4 although the effect is also reported as presenting independently of both cumulative dose and time. 8,15 Benitz et al 1 initially reported minocy c l i n e -i n d u c e d soft tissue pigmentation in 1967, the same year as its introduction into clinical practice, describing an abnormal discoloration in the thyroid gland in rats, dogs and monkeys. The pigmentation is caused by polymerization of the oxidation products, 9-hydroxy and N-demethylated derivatives, to form an ironbinding melanin-like molecule.…”

Section: Pigmentationmentioning

confidence: 99%

“…Black breast milk has also been described follow i n g minocycline administration. 8,21 Although one report indicated several years of therapy, another case occurred after only three weeks. Examination of the milk revealed macrophages containing pigmented particles consistent with haemosiderin, suggesting a similar pathogenesis to cutaneous pigmentation.…”

Section: Pigmentationmentioning

confidence: 99%

“…Although tetracyclines cause pigmentation of bones and teeth, minocycline alone is also responsible for soft tissue pigmentation. The effect is uncommon, but may involve the thyroid, 1 sclera, 2 oral mucosa, 3,4 skin, 5,6 nails, 7 breast milk 8 and cardiac valves, 9 in addition to bone and teeth. 10 Some fading may occur with time on discontinuing the drug, but permanent p i g m e n t ation is usual with attendant cosmetic problems.…”

Section: Introductionmentioning

confidence: 99%

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Minocycline and oral pigmentation

Cockings

Savage

1998

Australian Dental Journal

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Minocycline is a semisynthetic tetracycline used in the treatment of inflammatory acne because of its broad spectrum of activity, less common development of resistant organisms, and its anti-inflammatory e ffects. A number of adverse reactions are reported, including skin and oral pigmentation. This paper details the pharmacology of minocycline and describes the pigmentation and likely mechanisms active in both hard and soft tissues. Oral pigmentation usually involves the hard tissues only and presents typically as a discrete band occupying the central zone of the alveolar mucosa and palate. As with other sites, it may persist following withdrawal of the drug. Early recognition by the dental practitioner may allow an alternative form of therapy to be sought, minimizing the likelihood of a longterm aesthetic problem.

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“…The pigmentation can reach the conjunctiva, buccal mucosa [64, 69], lips [70] and bone to create a dark bone pigmentation severe enough to be visible through the alveolar and palatal mucosa [71]. A breast milk discoloration was reported: the milk had turned black 3–4 weeks after beginning therapy with 150 mg daily for acne [72]. These adverse reactions are important and worrying, but fortunately they are rare; so the treatment is usually safe [73].…”

Section: General Methods Of Treatment and Side Effectsmentioning

confidence: 99%

Systemic Antibiotics for Acne

Meynadier

Alirezai

1998

Dermatology

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Antibiotic therapy for acne is very common. Antibiotics are frequently used in acne, either systemically or topically. Systemic antibiotics are indicated as treatment of moderate and quite severe acne or if acne is considered as very serious by the patient for psychological or social reasons. Results are very often excellent, but failure is possible; in this case using another treatment, especially isotretinoin, is necessary. A few antibiotics are useful: tetracyclines (tetracycline, doxycycline, minocycline, lymecycline), erythromycin, co-trimoxazole and trimethoprim. Their side effects are reviewed. During pregnancy the best antibiotic is erythromycin. For the nursing mother it is generally said that tetracyclines are contraindicated but the risks if they exist are certainly slight. The mechanism of action of systemic antibiotics for acne is not perfectly clear as it is not only antimicrobial: they diminish chemotaxis of polymorphonuclear leukocytes, modify the complement pathways and inhibit the polymorphonuclear leukocyte chemotactic factor and the lipase production in Propionibacterium acnes.

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Black breast milk due to minocycline therapy

Cited by 30 publications

References 9 publications

Minocycline Toxicity: Case Files of the University of Massachusetts Medical Toxicology Fellowship

Minocycline Toxicity: Case Files of the University of Massachusetts Medical Toxicology Fellowship

Minocycline and oral pigmentation

Systemic Antibiotics for Acne

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