Minocycline.

Minocycline belongs to the second generation class of cyclines. II was synt hesized in 1967 and marketed in 1972. Minocycline has an antiinfectious act ivity with a spectrum similar to that of other cyclines, notably against Ch lamydias, Treonema and Proprionibacterium acenes. The antiinflammatory acti vity is associated with this antiinfectious action is greater than that of first generation cyclines with specifically a modulator effect on epidermal cytokines. The pharmokinetics of minocycline is characterized by an excellent absorpti on, a long half-life and an important lipophilic property inducing good tis sue distribution. Clinical trials of minocycline have mainly been performed in sexually trans missible diseases and in acne, a field where randomized studies are the mos t frequent. These trials show that the effect of minocycline is not stronge r than first generation cyclines or doxycycline, but that the action is qui cker than that of tetracycline at the dose of 500 mg a day. Minocycline is also efficient in nocardiasis, mycobacteriosis, leprosy, Lyme disease, pyod erma gangrenosum, autoimmune bullous dermatitis, Carteaud disease, and prur igo. However, the effect of minocycline in these different conditions has a lways been evaluated in open trials with a small number of patients. The usual side effects of cyclines, i.e. digestive problems, fungal infecti ons, are less frequent than with first generation cyclines. No photosensiti vity has been demonstrated although pigmentations have been described. Dizz iness is a specific side effect of minocycline. Furthermore, rare but sever e side effects have been reported, including hypersensitivity syndrome, aut oimmune hepatitis, and lupus. Regular indications for minocycline in dermat ology are acne and three sexually transmissible diseases (mycoplasm, chlamy dia, treponema). Proposed dosage is 100 mg per day in sexually transmissibl e disease with a reduction to 50 mg per day after 15 days in acne.