Minocycline-induced hyperpigmentation

Abstract

A 62-year-old male with a long history of rosacea, which was well controlled on minocycline, presented to his primary care physician for routine examination. Physical examination was noted for non-palpable, non-pruritic blue patches of hyperpigmentation on the medial aspects of his lower extremities bilaterally. Recognition and management of the findings are discussed.

Minocycline pigmentation of the vulva masquerading as a melanocytic lesion

“…Type I is the most common and appears as blue-black/grey pigment staining in areas of acne scarring or inflammation as seen in this patient. 5 Type II appears as blue-grey pigment on normal skin most commonly on the shins, legs, and forearms, also seen in this patient. Type III presents as diffuse muddy-brown discoloration on sun-exposed areas of the skin.…”

Minocycline-induced cutaneous hyperpigmentation

“…1 There are 4 distinct types of skin pigmentation described in the literature. [2][3][4] Type I minocycline-induced hyperpigmentation presents as blue-black macules at the site of previous inflammation and scarring, resulting from deposition of pigmented granules in the dermis. 2,3 Patients with type II minocycline-induced hyperpigmentation develop blue-grey discolouration on healthy skin of the extremities, most often the shins.…”

“…This occurs owing to deposition of minocycline metabolites in the skin. 2,3 Type III minocycline-induced hyperpigmentation presents as a muddy-brown discolouration in sun-exposed areas and may result from increased melanization of the skin basal cell layer. 2,3 Type IV minocyclineinduced hyperpigmentation has the same cause as type III and involves preexisting scars.…”

“…2,3 Type III minocycline-induced hyperpigmentation presents as a muddy-brown discolouration in sun-exposed areas and may result from increased melanization of the skin basal cell layer. 2,3 Type IV minocyclineinduced hyperpigmentation has the same cause as type III and involves preexisting scars. 4 Based on the distribution of the hyperpigmented patches, our patient had type III minocycline-induced hyperpigmentation.…”

Editor's Note

“…In addition, our radiology column is represented by a case of recurrent neurocysticercosis ( 13 ). And there are two image reports – a blue leg ( 14 ) and a red ear ( 15 ).…”