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Minocycline-Induced Scleral and Dermal Hyperpigmentation
Cheryl Haskes1, Michael Shea, David Imondi
1*OD †OD, FAAO VA Connecticut Healthcare System, Newington, Connecticut (CH, DI); and Blondin Shea Eye Care, Torrington, Connecticut (MS).
Summary
Long-term minocycline use can cause blue or black hyperpigmentation of the sclera, skin, and organs. While often reversible, this minocycline side effect typically does not cause vision loss or other health issues.
Area of Science:
- Ophthalmology
- Dermatology
- Pharmacology
Background:
- Minocycline, a tetracycline antibiotic, is widely used for various infections and inflammatory conditions.
- Adverse effects of minocycline can include hyperpigmentation, though scleral involvement is less common.
- Understanding minocycline's side effect profile is crucial for patient management.
Observation:
- A case report details an elderly male patient with bilateral blue scleral pigmentation.
- The patient also exhibited dermal hyperpigmentation and posterior segment pigment deposition.
- The condition was linked to prolonged oral minocycline therapy.
Findings:
- Minocycline-induced hyperpigmentation can affect the sclera, skin, and internal organs, presenting as blue or black discoloration.
- The exact mechanism of pigment deposition is not fully understood but is theorized to involve melanin or metabolite accumulation.
- While cosmetically noticeable, minocycline-induced hyperpigmentation is generally not associated with systemic or ocular morbidity.
Implications:
- This case highlights the importance of considering minocycline as a potential cause of scleral pigmentation.
- Differential diagnosis of blue sclera should include medication-induced causes.
- Awareness of this side effect aids in appropriate patient counseling and monitoring.
