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Hyperpigmentation associated with oral minocycline
Abstract:
Two patient receiving minocycline developed blue-black pigmentation on the legs. Biopsies from the pigmented areas demonstrated granules containing iron, a pigment with staining properties similar to melanin, and a third pigment which may be a degradation product of minocycline. Electron microscopy showed that some, but not all the granules were membrane-bound and they were situated mainly within macrophages. Analytical electron microscopy showed that the granules contained iron, sulphur, chlorine and, in one case, calcium.
Insights
Minocycline treatment can cause blue-black leg pigmentation due to iron-containing granules within macrophages. These granules may also contain minocycline degradation products, impacting skin histology.
Area of Science:
- Dermatology
- Histopathology
- Toxicology
Background:
- Minocycline is an antibiotic used to treat various infections and inflammatory conditions.
- Skin pigmentation is a known, though uncommon, side effect of minocycline therapy.
Observation:
- Two patients receiving minocycline presented with blue-black pigmentation on their legs.
- Biopsies of the affected skin revealed the presence of pigment granules.
Findings:
- The granules contained iron, exhibiting staining properties similar to melanin.
- A third, unidentified pigment, possibly a minocycline degradation product, was also observed.
- Electron microscopy indicated that granules were primarily within macrophages, some being membrane-bound.
- Analytical electron microscopy confirmed the presence of iron, sulfur, and chlorine within the granules, with calcium noted in one instance.
Implications:
- This study elucidates the histopathological basis of minocycline-induced hyperpigmentation.
- Understanding the composition of these pigment granules aids in diagnosing and managing this side effect.
- Further research may clarify the exact nature of the minocycline degradation product and its role in pigmentation.