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Conjunctival pigmentation associated with tetracycline medication

D M Brothers, A A Hidayat

    Ophthalmology
    |December 1, 1981
    PubMed
    Summary

    Long-term oral tetracycline use can cause dark conjunctival pigment deposits. These deposits, found in conjunctival cysts, contain calcium and exhibit tetracycline

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    Area of Science:

    • Ophthalmology
    • Dermatology
    • Pharmacology

    Background:

    • Acne vulgaris is commonly treated with oral antibiotics like tetracycline and minocycline.
    • Long-term antibiotic use can lead to various side effects, including pigmentary changes.

    Observation:

    • A 26-year-old male presented with bilateral dark brown to black pigmentary deposits in the palpebral conjunctiva.
    • The deposits were noted after 12 years of oral tetracycline and minocycline treatment for acne vulgaris.

    Findings:

    • Histological examination revealed pigmented concretions within conjunctival cysts.
    • These concretions contained calcium but showed characteristic yellow autofluorescence under ultraviolet light, indicative of tetracycline.

    Implications:

    • Tetracycline can form extracellular chelation complexes with calcium in the conjunctiva.
    • This mechanism explains the observed pigmentation, a previously unrecognized side effect of long-term oral tetracycline therapy.

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