minocycline and Acneiform-Eruptions

Postradiation comedogenesis is an uncommon side effect of radiation therapy, with few cases reported in the medical literature. The proposed etiology of this reaction is alteration of pilosebaceous unit secretions and retention of proliferating ductal keratinocytes due to stricture and scarring. We report a case of a 48-year-old woman who had been treated for infiltrating ductal carcinoma of the right breast with lumpectomy and radiation therapy. She subsequently developed open and closed comedones as well as tender inflammatory papules and papulopustules in the irradiated area. Our patient was treated with tretinoin cream and oral minocycline, with rapid improvement in symptoms and complete resolution of lesions after 2 months of therapy. We review the literature on the pathogenesis, clinical features, and treatment of postradiation acne, and discuss rapid resolution of a radiation-induced acneform eruption after combination treatment with tretinoin and minocycline.

Topics: Acneiform Eruptions; Administration, Cutaneous; Administration, Oral; Anti-Bacterial Agents; Drug Therapy, Combination; Female; Humans; Keratolytic Agents; Middle Aged; Minocycline; Radiation Injuries; Treatment Outcome; Tretinoin

Topics: Acneiform Eruptions; Adrenal Cortex Hormones; Antibodies, Monoclonal; Dose-Response Relationship, Drug; Drug Administration Schedule; Follow-Up Studies; Humans; Infliximab; Male; Minocycline; Psoriasis; Risk Assessment; Spondylitis, Ankylosing; Treatment Outcome; Young Adult

To evaluate the ability of either oral minocycline, topical tazarotene or both, to reduce or prevent cetuximab-related acneiform rash when administered starting on day 1 of cetuximab therapy.. Metastatic colorectal cancer patients preparing to initiate cetuximab were randomly assigned to receive daily oral minocycline or placebo, and to receive topical tazarotene application to either left or right side of the face. Both therapies were administered for 8 weeks.. Forty-eight eligible patients were randomly assigned to minocycline (n = 24) or placebo (n = 24). Total facial lesion counts were significantly lower in patients receiving minocycline at weeks 1 through 4. At week 4, a lower proportion of patients in the minocycline arm reported moderate to severe itch than in the placebo arm (20% v 50%, P = .05). Facial photographs, obtained at week 4, were reviewed for rash global severity. Patients in the minocycline arm trended toward lower frequency of moderate to severe rash than patients receiving placebo (20% v 42%, P = .13). The differences in total facial lesion counts and subjectively assessed itch were diminished by week 8. Cetuximab treatment was interrupted because of grade 3 skin rash in four patients in the placebo arm, and none in the minocycline arm. There was no observed clinical benefit to tazarotene application. Tazarotene treatment was associated with significant irritation, causing its discontinuation in one third of patients.. Prophylaxis with oral minocycline may be useful in decreasing the severity of the acneiform rash during the first month of cetuximab treatment. Topical tazarotene is not recommended for management of cetuximab-related rash.

Topics: Acneiform Eruptions; Administration, Oral; Administration, Topical; Adult; Aged; Aged, 80 and over; Antibodies, Monoclonal; Antibodies, Monoclonal, Humanized; Antineoplastic Agents; Cetuximab; Colorectal Neoplasms; Dermatologic Agents; Double-Blind Method; ErbB Receptors; Female; Humans; Male; Middle Aged; Minocycline; Nicotinic Acids; Placebos

Acneiform eruption is the most common cutaneous adverse event associated with cetuximab. As it can affect quality of life and adversely affect chemotherapy schedule, additional medical care is required.. To investigate the adherence to and the duration of antibiotic administration to treat cetuximab-induced acneiform eruption.. Medical data of patients who were referred to the Department of Dermatology were reviewed from January 2013 to June 2018. Dermatologists assessed the severity of acneiform eruption and prescribed tetracycline-class antibiotics according to the severity every 2 or 4 weeks. We investigated the duration and amount of oral antibiotic administration and analyzed the factors that may affect the control of acneiform eruption statistically.. A total of 207 of 267 patients referred to the Department of Dermatology showed acneiform eruption; 124 patients were treated with minocycline, 34 patients with doxycycline, 27 patients with both, and 22 patients with topical agents. The mean duration of oral antibiotic medication was 82.7 days. A statistical analysis of the factors that prolonged the use of antibiotics for more than 90 days showed that male and younger age were risk factors. Shorter time interval from starting cetuximab to starting antibiotics was associated with longer duration of antibiotic use, statistically.. Cetuximab-induced acneiform eruption can be well controlled with tetracycline-class antibiotics in about 3 months. It can last longer in male and younger patients. The sooner and the more severe it appears, the longer it can last.

Topics: Acneiform Eruptions; Administration, Oral; Anti-Bacterial Agents; Antineoplastic Agents, Immunological; Cetuximab; Doxycycline; Drug Administration Schedule; Female; Humans; Male; Medication Adherence; Middle Aged; Minocycline; Retrospective Studies

Topics: Acneiform Eruptions; Administration, Topical; Adult; Antibodies, Monoclonal, Humanized; Benzoyl Peroxide; Breast Neoplasms; Carcinoma, Ductal, Breast; Clindamycin; Drug Eruptions; Female; Humans; Middle Aged; Minocycline; Receptor, ErbB-2; Trastuzumab

Erlotinib has been reported as being associated with a high incidence of skin toxicities such as acneiform rash, paronychia, and xerosis.. The aim of this study was to evaluate the efficacy of prophylactic minocycline treatment for the skin toxicities induced by erlotinib as compared with deferred minocycline treatment in patients with pancreatic cancer treated with erlotinib plus gemcitabine.. A total of 96 patients were studied retrospectively, of whom 44 received prophylactic minocycline between August 2012 and June 2013 and 52 received deferred minocycline treatment between August 2011 and July 2012 at the National Cancer Center Hospital East, Kashiwa, Japan. In the prophylactic minocycline group, 200 mg/day oral minocycline was prophylactically administered during the treatment period.. The incidence rate of acneiform rash and xerosis of any grade during the first 6 weeks of treatment was significantly reduced in the prophylactic minocycline group compared with the deferred minocycline treatment group (47.7 vs. 80.8%, p<0.001; 2.3 vs. 19.2%, p=0.01). Multivariate analysis identified prophylactic minocycline as a significant independent factor associated with the incidence of acneiform rash and xerosis of any severity (odds ratio [OR] 0.16, 95% confidence interval [CI] 0.06-0.46, p<0.001; OR 0.11, 95% CI 0.01-0.90, p=0.04).. Prophylactic minocycline appears to be useful for the management of erlotinib-related acneiform rash and xerosis during chemotherapy in patients with advanced pancreatic cancer.

Topics: Acneiform Eruptions; Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Deoxycytidine; Dermatologic Agents; Drug Eruptions; Erlotinib Hydrochloride; Female; Gemcitabine; Humans; Male; Middle Aged; Minocycline; Pancreatic Neoplasms; Retrospective Studies

Although the anti-EGFR monoclonal antibody panitumumab is effective in treating colorectal cancer, the occurrence of severe skin disorders often discontinues therapy. Herein, we investigated by a retrospective chart review the effect of prophylactic oral minocycline in combination with skin treatment using moisturizer on the incidence of skin disorders and tumor response in metastatic colorectal cancer patients who received panitumumab.. In a total of 55 patients, 38 patients were eligible, consisting the pre-emptive group (N=25) and reactive group (N=13). Acneiform rash and other adverse events were graded according to the CTCAE v4.0.. The occurrence of acneiform rash (grade ≥2) was significantly lower in pre-emptive group than in reactive group (44.0% vs. 84.6%, p=0.04). No significant differences in the occurrence of other adverse events were observed between the two groups. Tumor response was not significantly different between the two groups (36.0% vs. 7.7%, OR, 6.75; 95% confidence interval (CI)=0.75-60.76, p=0.12). Mean time to treatment failure was 149.7 days and 110.2 days in the pre-emptive group and reactive treatment group, respectively (HR=0.58; 95% CI= 0.26-1.28, p=0.18).. Prophylactic oral minocycline combined with skin care reduced panitumumab-induced acneiform rash without a significant influence on tumor response.

Topics: Acneiform Eruptions; Administration, Oral; Administration, Topical; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Antibodies, Monoclonal; Antineoplastic Agents; Cohort Studies; Colorectal Neoplasms; Drug Therapy, Combination; Exanthema; Female; Follow-Up Studies; Humans; Liver Neoplasms; Male; Middle Aged; Minocycline; Neoplasm Staging; Panitumumab; Prognosis; Skin Care

Topics: Acneiform Eruptions; Anti-Bacterial Agents; Biopsy; Cyclosporine; Drug Therapy, Combination; Glucocorticoids; Humans; Immunosuppressive Agents; Male; Minocycline; Prednisolone; Severity of Illness Index; Skin; Treatment Outcome; Young Adult

Topics: Acneiform Eruptions; Adult; Anti-Bacterial Agents; Eyelid Diseases; Humans; Male; Minocycline; Treatment Outcome

Steroid acne is a folliculitis that can result from systemic or topical administration of steroid, and has been described as showing a similar clinical picture to Pityrosporum folliculitis, but there have been few reports about the incidence of Pityrosporum ovale and the effect of antimycotic drugs in steroid acne and other acneiform eruptions. Our purpose was to describe the association between steroid acne and P. ovale, and to confirm the superior efficacy of oral antifungal drugs over anti-acne drugs in the treatment of steroid acne.. The history, clinical features direct microscopy, histopathologic analysis, and therapeutic results of 125 cases with steroid acne or other acneiform eruptions were described and compared.. Over 80% of patients with acneiform eruption receiving systemic steroid revealed significant numbers of P. ovale in the lesional follicle. Furthermore, oral antifungal drug (itraconazole) showed significantly better clinical and mycologic effects than any other group of medications used in this study.. Steroid acne and other acneiform eruptions showing discrete follicular papules and/or pustules localized to the upper trunk and acneiform facial skin lesions associated with multiple acneiform lesions on the body in the summer period should be suspected as Pityrosporum folliculitis. In addition, oral antifungal drugs recommended for Pityrosporum folliculitis; however, it will require a larger case-control study to confirm the superiority of antifungal therapy over anti-acne treatment.

Topics: Acne Vulgaris; Acneiform Eruptions; Adolescent; Adult; Anti-Bacterial Agents; Antifungal Agents; Dermatomycoses; Diagnosis, Differential; Female; Folliculitis; Hair Follicle; Humans; Incidence; Itraconazole; Korea; Malassezia; Male; Miconazole; Microscopy; Middle Aged; Minocycline; Skin; Spores; Treatment Outcome