Minocycline hyperpigmentation

Several recent studies have documented the efficacy and safety of minocycli ne in the treatment of mild rheumatoid arthritis. Reported side effects ten d to be mild, with gastrointestinal disturbances, headaches, vestibular dys function, and photosensitive rashes being the most common. Hyperpigmentatio n of skin and other structures has also been reported but seems to be uncom mon and usually dose-related. The different types of skin hyperpigmentation are reviewed, including their histopathologic and clinical distinctions, p ossible predisposing factors, and treatment. Our experience suggests that steroid use, advanced age, cumulative minocycl ine dosage, and possibly the brand of minocycline may be predisposing risk factors for developing hyperpigmentation. It is quite possible that this ad verse effect is more common than previously recognized, and we suggest that physicians prescribing minocycline be observant for skin hyperpigmentation . Although most of our patients with hyperpigmentation chose to continue th e medication (61%), it must be discontinued for the hyperpigmentation to re solve.