minocycline and Gingival-Diseases

The aim of this study was to evaluate the therapeutic benefit of minocycline in mucous membrane pemphigoid (MMP) predominantly involving the oral cavity. A descriptive, open clinical study with no control group, including 9 patients, was developed. The diagnosis was confirmed by histopathological examination and direct and salt-split-skin indirect immunofluorescence analysis. Target antigens were sought by immunoblotting. Patients received minocycline (200mg/day) for a variable period. All patients were followed up for at least 2 years after initial diagnosis. Therapeutic response was assessed by clinical improvement in three categories: major response, minor response and no response. A major response was observed in 3 patients (33%), a minor response in 4 (44%) and 2 (22%) patients showed no improvement. Two of the 3 patients with a major response showed no immunoblot reactivity; 80% of patients with circulating autoantibodies (autoAb) against BP180 had a minor or no response. Permanent remission of signs with no relapse was only obtained in one patient. 5 patients (55%) stopped the drug because of adverse effects, such as vertigo and gastralgia. The results revealed temporary clinical benefits in MMP predominantly involving the oral cavity with minocycline, although frequently side effects led to drug withdrawal.

Topics: Administration, Oral; Administration, Topical; Aged; Anti-Bacterial Agents; Clobetasol; Complement C3; Drug Combinations; Female; Fluorescent Antibody Technique, Indirect; Gingival Diseases; Glucocorticoids; Humans; Immunoglobulin A; Immunoglobulin G; Middle Aged; Minocycline; Pemphigoid, Benign Mucous Membrane; Treatment Outcome; Vertigo

Topics: Aged; Anti-Bacterial Agents; Face; Female; Gingival Diseases; Humans; Hyperpigmentation; Minocycline; Pigmentation Disorders; Rosacea

Topics: Adult; Anti-Bacterial Agents; Diagnosis, Differential; Female; Gingival Diseases; Humans; Minocycline; Pigmentation Disorders

Dentists generally recognize the importance of periodontal treatment in patients with leukemia, with the most attention paid to preventing the development of odontogenic infection. For physicians, the worst type of infection is one caused by multidrug-resistant bacteria. Here, we report a patient with an abnormal increase in multidrug-resistant opportunistic bacteria in the gingiva during hematopoietic cell transplantation (HCT).. A 53-year-old woman receiving HCT for leukemia had an insufficient blood cell count for invasive periodontal treatment before HCT. Even brushing caused difficulties with hemostasis. Therefore, frequent pocket irrigation and local minocycline administration were performed.. The multidrug-resistant opportunistic bacterium Stenotrophomonas maltophilia was detected first in phlegm 2 days before HCT, and it was detected in a gingival smear and a blood sample 7 and 11 days after HCT, respectively. The patient developed sepsis on day 11 and died 14 days after HCT. Frequent irrigation and local antibiotic application were ineffective against S. maltophilia on the gingiva. Inflammatory gingiva without scaling and root planing showed bleeding tendency, and this interfered with the eradication of this bacterium.. The gingiva in patients undergoing leukemia treatment acts as sites of proliferation and reservoirs for multidrug-resistant opportunistic bacteria. Severe systemic infection by multidrug-resistant bacteria in such patients with leukemia also may involve the gingiva. To prevent abnormal increases in such bacteria on the gingiva, scaling and/or root planing before chemotherapy, which reduces bleeding on brushing during the neutropenic period caused by chemotherapy, may contribute to infection control in such patients, although it was impossible in this case.

Topics: Anti-Bacterial Agents; Anti-Infective Agents, Local; Drug Resistance, Multiple, Bacterial; Fatal Outcome; Female; Gingival Diseases; Gingivitis; Gram-Negative Bacterial Infections; Hematopoietic Stem Cell Transplantation; Humans; Immunocompromised Host; Leukemia, Myeloid, Acute; Middle Aged; Minocycline; Opportunistic Infections; Periodontitis; Povidone-Iodine; Sepsis; Stenotrophomonas maltophilia; Transplantation Conditioning; Whole-Body Irradiation

Topics: Acne Vulgaris; Adult; Anti-Bacterial Agents; Female; Gingival Diseases; Humans; Minocycline; Pigmentation Disorders

Oral mucosal pigmentation is an infrequently reported side effect of minocycline. Two patients with minocycline deposition within teeth and bone, demonstrated by fluorescence microscopy, are described. Minocycline is the only tetracycline reported to cause discoloration of the oral mucosa. This may be the result of deposition of an insoluble degradation product of minocycline in the underlying bone. Pigmentation is not necessarily dose-dependent and may take months or years to resolve.

Topics: Adult; Alveolar Process; Color; Female; Gingival Diseases; Humans; Hyperpigmentation; Minocycline; Mouth Diseases; Mouth Mucosa; Palate

Oral pigmentation due to minocycline hydrochloride (Minocin) therapy is an unusual and infrequently reported side effect of the drug. This report describes a patient on long-term minocycline therapy who presented with gingival pigmentation. Upon surgical exploration, the gingiva was noted to be normal in color, but the underlying bone was deeply pigmented. Via fluorescent microscopy, minocycline deposition within the alveolar bone was demonstrated.

Topics: Adult; Alveolar Process; Gingival Diseases; Humans; Jaw Diseases; Male; Minocycline; Pigmentation Disorders; Tetracyclines