Minocycline as a therapeutic option in bullous pemphigoid

Abstract

We present a retrospective analysis of patients with bullous pemphigoid (BP) treated with minocycline in the Department of Dermatology, Churchill Hospital, Oxford between July 1986 and May 2000. More than 200 patients with BP were seen in clinic during the review period. Of these, 22 patients were treated with minocycline, mostly as adjuvant therapy. The response to treatment was assessed by clinical improvement and whether the dose of concurrent immunosuppressive drugs was subsequently reduced. A major response was seen in six patients, a minor response in 11 and no response was seen in five patients. Minocycline was discontinued in four patients because of the occurrence of side-effects. Overall analysis revealed marked clinical benefits of minocycline in BP. However, this is a non-placebo controlled study and should now be followed by a prospective double-blind controlled clinical trial.

Systemic minocycline as a therapeutic option in predominantly oral mucous membrane pemphigoid: a cautionary report

“…The ratios of definite and major response to minocycline were similar to those reported by LOO et al for a closely related disease, such as bullous pemphigoid (78% vs. 77% and 33% vs. 23%, respectively) 15 . Patients without circulating autoantibodies against BP180 showed a better clinical response to minocycline.…”

“…When being used to treat bullous pemphigoid and MMP, minocycline has been associated with several adverse events, such as a photosensitive rash, hyperpigmentation, drug-induced systemic lupus erythematosus, gastrointestinal discomfort, serum sickness, hypersensitivity pneumonitis, dizziness and vertigo 12,[15][16][17][18][19][20] . Vertigo was the most common side effect in the present study, leading to cessation of the medication in 44% of patients.…”

“…The same investigator (MC) performed the follow-up examination, for the duration of the study. To compare the therapeutic response of minocycline with the previously reported data, clinical improvement was determined as reported by LOO et al 15 : a major response was recorded if there was complete clearance with no new lesions developing for at least 6 months; a minor response indicated reduction of disease activity but some new lesions developing; and no response meant no reduction in blister formation 15 . Clinical photographs were taken at each visit for comparison.…”

Tetracyclines: Nonantibiotic properties and their clinical implications

“…Tetracycline or minocycline, alone or in combination with nicotinamide, were shown to be effective in bullous dermatoses affecting the dermoepidermal junction, such as bullous pemphigoid, cicatricial pemphigoid, linear IgA disease, and lichen planus pemphigoides. [43][44][45][46][47][48][49][50][51][52][53] These reports are generally uncontrolled, and it is possible that a selection bias toward patients with milder disease or spontaneous remission may be operative. Additional studies are also necessary to evaluate whether tetracycline in combination with nicotinamide is more effective than either of the two drugs administered as monotherapy.…”

Treatment of linear IgA bullous dermatosis of childhood with flucloxacillin

“…[13][14][15] Other immunobullous diseases including bullous pemphigoid and linear IgA bullous dermatosis of adulthood have responded to different antibiotics including tetracyclines and erythromycin. [16][17][18][19][20][21][22][23] Herein we describe 7 cases of linear IgA bullous dermatosis of childhood treated effectively with flucloxacillin, causing rapid and lasting remission in 4 cases and excellent control in the remaining ones.…”