MINOCYCLINE-INDUCED SCLERAL PIGMENTATION

Purposes: Minocycline is a commonly used drug in the management of acn e and rosacea. Four individual cases of oral minocycline-induced scler al pigmentation are reported in the dermatologic literature, This is t he first report in the ophthalmic literature and will add three new ca ses of probable minocycline-induced scleral pigmentation. Materials an d Methods: Data on minocycline from the spontaneous reporting systems of the National Registry of Drug-induced Ocular Side Effects, Food and Drug Administration, World Health Organization, and Lederle Laborator ies were reviewed as to minocycline-related scleral pigmentation, Phot ographs, published cases, discussions with the examining ophthalmologi sts, and the personal observation of one patient (case 1) are the basi s of the authors' conclusions. Results: Seven cases of probable oral m inocycline-induced sclera[ pigmentation are presented, These changes m ay or may not be associated with minocycline-induced pigmentary change s in other tissues, such as the skin, teeth, fingernails, bone, thyroi d, or mucosa. The characteristic scleral pattern is a blue-gray 3- to 5-mm band starting at the limbus, which usually is enhanced in the pal pebral aperture, possibly due to the photosensitizing properties of th e drug. Conclusions: Oral minocycline can cause scleral pigmentation. This pigmentation may resolve within years, or it may be permanent.