Drug Hypersensitivity Syndrome Caused by Minocycline

Abstract

Minocycline is able to elicit a drug hypersensitivity syndrome that can resemble infectious mononucleosis. This drug reaction can be treated effectively by cessation of exposure to this drug and steroid therapy.

Dermatology: how to manage acne in skin of colour

“…43 Minocycline-induced DHS has been reported in a 20-year-old Japanese patient treated for acne. 44 A fatal case of DHS was also reported in a 15-year-old African girl treated with minocycline for acne. 45 In addition to these hypersensitivity reactions, other AEs of minocycline include autoimmune disorders (polyarteritis nodosa, autoimmune hepatitis and lupus-like syndrome) as well as blue/black/grey discoloration of the skin, nails, teeth, sclera, oral mucosa, thyroid, heart valves and bones.…”

“…Treatment expectations should be discussed because it may take 3–6 months to reach treatment efficacy, 50 and relapses are common if the medication is discontinued. 44 There have not been specific studies assessing the role of OCP for acne in patients with SOC. However, OCP should be considered in any woman with SOC who requires birth control, is not planning a family or presents with features of hormonal acne.…”

Tetracycline Allergy

“…There are some reports of viral infections triggering a decreased metabolism or the formation of reactive metabolites from minocycline causing the proliferation of T-cells and cytokine release [34]. The reactive iminoquinone metabolite may contribute to this and activate specific viruses, such as human herpesvirus type 6, which can cause a late-phase reaction [38]. Tetracycline and doxycycline are not metabolized to iminoquinone derivatives, which explains the proclivity of this reaction to be with minocycline.…”

Case Report: Minocycline-induced drug reaction with eosinophilia and systemic symptoms syndrome: a case report and literature review

“…To perform a thorough literature review, we searched PubMed and Embase databases by using “Drug reaction with eosinophilia and systemic symptoms”, “DRESS syndrome”, “drug-induced hypersensitivity reaction”, “DIHS”, “Drug Hypersensitivity Syndrome”, or “DHS”, and “minocycline” as keywords. After screening and assessment, a total of 13 eligible cases were included for analysis ( Tsuruta et al, 2006 ; Brown et al, 2009 ; Eshki et al, 2009 ; Shaughnessy et al, 2010 ; Taylor et al, 2012 ; Kanno et al, 2014 ; Wu and Anadkat, 2014 ; Lan et al, 2015 ; Kirchhof et al, 2016 ; Gowani et al, 2018 ; Kudlaty et al, 2023 ; Shea et al, 2023 ; Zhao et al, 2023 ) ( Supplementary Figure S2 ). The clinical characteristics of these cases were summarized and demonstrated in Table 1 .…”