A 36-year-old man was treated with dapsone, rifampicin and clofazimine
for borderline lepromatous leprosy, After 9 months, his leprosy plaqu
es became progressively more red and after 23 months, the clofazimine
was stopped and he was given minocycline instead. Six weeks later, he
developed blue-black pigmentation in his leprosy lesions. The histolog
y was consistent with minocycline-induced hyperpigmentation. This is t
he first report of minocycline-induced pigmentation in leprosy. We sug
gest it is important to consider this side-effect before the administr
ation of minocycline in leprosy, particularly if it is prescribed in p
lace of clofazimine.