minocycline and Folliculitis

We report two cases of drug-induced vasculitis subsequent to long-term minocycline therapy. Case 1; A 27-year-old woman, who was receiving minocycline hydrochloride for eosinophilic pustular folliculitis of 68-months'duration, showed polyarthralgia, intermittent low-grade fever, and light red reticulated erythemas with subcutaneous nodules on her extremities. Case 2; A 31-year-old man developed reddish-brown, reticulated erythemas with induration on bilateral lower legs after 24-months' duration of minocycline hydrochloride treatment for hidradenitis suppurativa. In both cases, skin biopsies demonstrated vasculitis affecting a small-sized artery at the border of the dermis and subcutis. Serum antineutrophil cytoplasmic antibodies (ANCA) showed borderline elevation. In both cases cessation of minocycline administration resulted in rapid improvement of cutaneous lesions and constitutional symptoms. Recently, attention has been focused on drug-induced ANCA-positive vasculitis. Accumulation of previous case reports of minocycline-induced vasculitis with cutaneous lesions disclosed that the duration of the treatment before clinical symptoms averaged 35 months. Patients may present with livedoid skin lesions accompanied by fever, polyarthritis, autoimmune hepatitis and drug-induced lupus. Early recognition of ANCA-positive vasculitis is essential during long-term minocycline treatment, because cessation of the drug can result in complete resolution.

Topics: Adult; Anti-Bacterial Agents; Antibodies, Antineutrophil Cytoplasmic; Female; Folliculitis; Hidradenitis; Humans; Male; Minocycline; Vasculitis, Leukocytoclastic, Cutaneous

Topics: Anti-Bacterial Agents; Fingers; Folliculitis; Humans; Male; Minocycline; Nails; Onycholysis; Pigmentation Disorders; Young Adult

Female pattern hair loss affects many women; its pathogenetic basis has been held to be similar to men with common baldness.. The objective of this study was to determine the role of immunity and inflammation in androgenetic alopecia in women and modulate therapy according to inflammatory and immunoreactant profiles.. 52 women with androgenetic alopecia (AA) underwent scalp biopsies for routine light microscopic assessment and direct immunofluroescent studies. In 18 patients, serologic assessment for antibodies to androgen receptor, estrogen receptor and cytokeratin 15 was conducted.. A lymphocytic folliculitis targeting the bulge epithelium was observed in many cases. Thirty-three of 52 female patients had significant deposits of IgM within the epidermal basement membrane zone typically accompanied by components of complement activation. The severity of changes light microscopically were more apparent in the positive immunoreactant group. Biopsies from men with androgenetic alopecia showed a similar pattern of inflammation and immunoreactant deposition. Serologic assessment for antibodies to androgen receptor, estrogen receptor or cytokeratin 15 were negative. Combined modality therapy with minocycline and topical steroids along with red light produced consistent good results in the positive immunoreactant group compared to the negative immunoreactant group.. A lymphocytic microfolliculitis targeting the bulge epithelium along with deposits of epithelial basement membrane zone immunoreactants are frequent findings in androgenetic alopecia and could point toward an immunologically driven trigger. Cases showing a positive immunoreactant profile respond well to combined modality therapy compared to those with a negative result.

Topics: Adult; Aged; Aged, 80 and over; Alopecia; Anti-Bacterial Agents; Female; Folliculitis; Humans; Immunoglobulin M; Middle Aged; Minocycline; Photochemotherapy; Treatment Outcome; Young Adult

Topics: Adrenal Cortex Hormones; Adult; Anti-Bacterial Agents; Eosinophilia; Female; Folliculitis; Histamine Antagonists; HIV Infections; Humans; Minocycline; Mucinosis, Follicular

Lupoid sycosis is a rare cicatricial form of chronic folliculitis commonly seen in men after puberty. It usually involves the beard area and is refractory to treatment. We here report two cases of lupoid sycosis; one had additional involvement of the pubic area. Both patients showed complete clearance with minocycline.

Topics: Adult; Biopsy, Needle; Chronic Disease; Facial Dermatoses; Folliculitis; Follow-Up Studies; Humans; Immunohistochemistry; Male; Minocycline; Pubic Bone; Severity of Illness Index; Treatment Outcome

Topics: Anti-Bacterial Agents; Folliculitis; Humans; Male; Middle Aged; Minocycline; Nail Diseases; Pigmentation

Ofuji's disease, also referred to as classic eosinophilic pustular folliculitis, is a rare dermatosis of unknown origin for which there is no uniformly effective treatment.. Twenty patients with Ofuji's disease (classic eosinophilic pustular folliculitis) evaluated in our department from January 1978 to June 1999 were studied clinically and histopathologically. Laboratory data, treatments, and clinical courses were evaluated in 12 of these individuals.. Nissl modified staining revealed moderate increases of mast cells around hair follicles and sebaceous glands in all 20 patients; the majority of the infiltrating mast cells were tryptase-positive and chymase-negative. Eight of 11 patients treated with oral indomethacin responded completely.. Indomethacin is an effective therapy for Ofuji's disease. Tryptase-positive and chymase-negative mast cells might play some role in the pathogenesis of Ofuji's disease.

Topics: Adolescent; Adult; Anti-Inflammatory Agents, Non-Steroidal; Arm; Back; Dapsone; Facial Dermatoses; Female; Folliculitis; Foot; Humans; Immunohistochemistry; Indomethacin; Japan; Male; Mast Cells; Middle Aged; Minocycline; Prednisolone; Sulfamethoxazole; Thorax; Treatment Outcome

Pneumonitis with eosinophilia is one of the less common and severe adverse effects of minocycline. The disease evolves in days or weeks from the beginning of treatment, and is usually characterized by dyspnea, fever and bilateral infiltrates in the chest X-ray. With cessation of the antibiotic, and sometimes adding cortico-steroids, clinical and roentgenological resolution follow. We present a case given minocycline for folliculitis and 3 weeks later fever, cough and shortness of breath developed. The clinical and roentgenological course was consistent with minocycline pneumonitis accompanied by eosinophilia.

Topics: Adult; Anti-Bacterial Agents; Eosinophilia; Folliculitis; Humans; Male; Minocycline; Pneumonia

Topics: Adult; Anti-Bacterial Agents; Chronic Disease; Facial Dermatoses; Folliculitis; Follow-Up Studies; Humans; Male; Minocycline

A common adverse effect of minocycline therapy is cutaneous pigmentation. We describe two patients who presented with hyperpigmentation caused by minocycline. One patient, aged 54 years, had taken minocycline due to lung silicosis for 3 years before black pigmentation of the face occurred. The other 49 year-old patient developed grey-black hyperpigmentation on both lower legs after a 6-month therapy with minocycline for folliculitis. This patient was treated with the Q-switched ruby laser and the pigmentation resolved in the treated area. The different clinical and histological forms of minocycline-induced hyperpigmentation are discussed.

Topics: Administration, Oral; Anti-Bacterial Agents; Antibiotic Prophylaxis; Drug Eruptions; Folliculitis; Humans; Hyperpigmentation; Long-Term Care; Male; Microscopy, Electron; Middle Aged; Minocycline; Silicosis; Skin

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

Topics: Acute Disease; Anti-Bacterial Agents; Cytokines; Drug Eruptions; E-Selectin; Female; Folliculitis; Humans; Middle Aged; Minocycline; Psoriasis; Sjogren's Syndrome; Skin Diseases, Vesiculobullous

This report describes a patient with a drug reaction and histologic changes of both eosinophilic cellulitis and eosinophilic pustular folliculitis. We propose that some cases of eosinophilic pustular folliculitis, like eosinophilic cellulitis, may occur as a result of a hypersensitivity phenomenon.

Topics: Cellulitis; Drug Eruptions; Eosinophilia; Folliculitis; Humans; Male; Middle Aged; Minocycline