minocycline and Cicatrix

A 20-year-old woman presented with a heavily pigmented scar on the left lower abdomen following excision of a benign compound nevus. Reexcision showed an organizing scar with pronounced hemosiderinlike pigment deposition and no residual melanocytic lesion. Results of further histopathologic workup showed positive staining with both Perls stain for iron and Fontana-Masson stain. These findings led to further questioning of the patient, which revealed a history of minocycline therapy--information that had not been provided during her initial evaluation. Hyperpigmented scars may result from minocycline ingestion. We present a review of the literature, with particular regard to the possible mechanisms of minocycline hyperpigmentation and the differential diagnosis of hyperpigmented scars.

Topics: Abdomen; Adult; Anti-Bacterial Agents; Cicatrix; Diagnosis, Differential; Female; Humans; Melanoma; Minocycline; Nevus, Pigmented; Skin Neoplasms

Acne vulgaris varies in clinical severity, from minimal comedonal disease to severe hemorrhagic and ulcerative lesions with scarring. While a family history confers a higher risk for developing acne, the correlation between heritability and clinical severity remains unclear.. To examine the natural history and heritability of severe acne with scarring in patients undergoing isotretinoin therapy.. A total of 101 subjects with severe acne with scarring and its variants, including acne conglobata and acne fulminans, were enrolled. All subjects and adult family members underwent an interview regarding their acne, and a corresponding "historical" Investigator's Global Assessment (hIGA) score (0 = clear, 1 = almost clear, 2 = mild, 3 = moderate, 4 = severe, 5 = very severe) was assigned. Study assessors performed an "examination" Investigator's Global Assessment (eIGA) based on the clinical examination of each subject (0 = clear, 1 = almost clear, 2 = mild, 3 = moderate, 4 = severe, 5 = very severe). A detailed family history and pedigree were documented.. Most subjects were Caucasian (44.5%) and male (79.2%) who had previously used doxycycline and/or minocycline (86.1%). The mean eIGA and hIGA scores were 2.7 and 4.4, respectively. 37.2% of subjects had one first-degree relative with a history of moderate or severe acne with scarring; of note, of the patients with hemorrhagic disease, 30% had at least one parent with moderate or severe acne.. Severe forms of acne often "cluster" in families, underscoring the heritable nature of acne and the prognostic value of a family history of moderate or severe disease.

Topics: Acne Vulgaris; Adult; Cicatrix; Doxycycline; Female; Humans; Isotretinoin; Male; Minocycline; Treatment Outcome

Frontal fibrosing alopecia (FFA) is a type of scarring hair loss primarily observed in postmenopausal women and characterized by fronto-tempero-parietal hairline recession, perifollicular erythema, and loss of eyebrows. The incidence is unknown, but the number of women presenting with this condition has significantly increased in recent years. No effective therapy has been established.. The purpose of this study is to present pertinent demographic and clinical findings of patients with FFA seen at an academic hair loss clinic and their responses to various therapeutic interventions.. Patients seen at the Duke University Hair Disorders Research and Treatment Center, Durham, NC, between 2004 and 2011 who met FFA inclusion criteria and signed an informed consent form for participation in the Duke University Hair Disorders Research and Treatment Center database were included in this review.. Nineteen female patients with FFA met our inclusion criteria, the majority of whom were white and postmenopausal. A number of treatments, including topical and intralesional steroids, antibiotics, and immunomodulators, were used with disappointing results in most patients. However, the majority of patients on dutasteride experienced disease stabilization.. This was a retrospective review and outside clinic records were occasionally incomplete.. FFA is an increasingly common form of scarring hair loss, but the origin remains unknown. Without clear understanding of the pathogenesis and evolution of this condition, it is not surprising that treatments to date have been minimally or not effective. At our institution, dutasteride was most effective in halting disease progression, although no therapy was associated with significant hair regrowth.

Topics: 5-alpha Reductase Inhibitors; Adult; Aged; Alopecia; Anti-Bacterial Agents; Azasteroids; Cicatrix; Dutasteride; Enzyme Inhibitors; Eyebrows; Female; Fibrosis; Forehead; Hospitals, University; Humans; Hydroxychloroquine; Immunosuppressive Agents; Lichen Planus; Methotrexate; Middle Aged; Minocycline; Osteoporosis, Postmenopausal; Retrospective Studies; Scalp; Tacrolimus; Treatment Outcome

Topics: Animals; Anti-Inflammatory Agents, Non-Steroidal; Cicatrix; Cicatrix, Hypertrophic; Disease Models, Animal; Humans; Hyperpigmentation; Minocycline; Rats; Wound Healing

Fifty-four patients taking minocycline for acne or rosacea were assessed for adverse effects. Their mean duration of treatment was 17 months, and their average cumulative dose was 47 g. No symptoms attributable to the therapy were reported. Biochemistry and haematology profiles were normal. There was no evidence of an adverse effect on thyroid function. Skin pigmentation was detected in eight patients (14.8%). Five patients had diffuse facial pigmentation, and three patients had localized pigmentation at the site of a scar or injury. Diffuse pigmentation occurred only in patients who had been on treatment for 3 years or more; 50% of such patients were affected. Age and solar damage may also have been factors in this type of pigmentation. Localized pigmentation occurred at sites of previous tissue damage, and was not directly related to the duration of therapy. Patients who receive long-term minocycline therapy should be regularly monitored for the development of pigmentation.

Topics: Acne Vulgaris; Adolescent; Adult; Age Factors; Aged; Cicatrix; Facial Dermatoses; Female; Humans; Male; Middle Aged; Minocycline; Pigmentation Disorders; Rosacea; Skin Aging; Skin Pigmentation; Thyroid Gland; Thyrotropin; Thyroxine; Time Factors

Topics: Acne Vulgaris; Administration, Topical; Adrenal Cortex Hormones; Benzoyl Peroxide; Cicatrix; Contraceptives, Oral, Hormonal; Humans; Isotretinoin; Minocycline; Propionibacterium acnes; Tetracycline; Tretinoin