Muco-cutaneous pigmentation and photosensitization induced by minocycline hydrochloride

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Abstract
Photosensitive rashes and cutaneous pigmentation induced by minocycline hydrochloride have been reviewed from the cases notified to the French Centres of Pharmacovigilance from 1984 to 1996 (24 cases) and from data available from literature (53 cases). Overall, 77 observations were reported: 13 photosensitive rashes, 52 skin pigmentations (17 cases of localized pigmentation and 35 cases of diffuse pigmentation) and 12 ungual and intraoral pigmentations. Photosensitive rashes occurred mainly among young women (77% of cases, mean age 31.7 ± 10.6 years) who had received weak cumulative doses of minocycline hydrochloride (mean 2 ± 1.32 g). Localized pigmentation mainly affected young women (76.5% of cases, mean age 28.1 ± 10.7 years) and appeared after intake of moderate cumulative doses (mean 35.1 ± 29.1 g), whereas diffuse pigmentation occurred mostly in men (65.7% of cases), with a higher mean age (54.9 ± 16.1 years) and distinctly higher cumulative doses (mean 177.9 ± 126.9 g). Pigmentary changes in the nails and mouth occurred in ten women and two men (mean age 29.4 ± 8.7 years) who had absorbed a mean of 101.3 ± 114.1 g. The recovery period is variable and is dependent upon the duration of treatment and on the cumulative dose intake. The pigments involved seem to be predominantly minocycline deposits in localized pigmentation and iron plus melanin in diffuse pigmentation.