minocycline and Melanosis

Intra-oral minocycline staining of alveolar bone and teeth is well-described in the literature. Minocycline-induced discoloration of oral soft tissues is less common and has been often attributed to staining of the underlying bone.. This report documents the clinical and histopathologic features of a case of actual oral soft tissue minocycline-induced pigmentation. The patient, a 45-year-old Caucasian female, presented with pigmentation of the gingiva, lips, and nail beds of recent onset. The past medical history revealed initiation of minocycline therapy 6 months earlier for dermatological concerns. Histopathologic examination of biopsy specimens from the gingiva and lip showed evidence of increased melanin/melanocytes in the epithelium and melanin/melanophages in the connective tissue. A working diagnosis of drug-associated pigmentation was determined and the patient discontinued immediately minocycline therapy. Nine months after cessation of minocycline the patient exhibited a marked reduction in pigmentation.. Systemic minocycline treatment has the potential to induce significant and esthetically objectionable discoloration of the gingiva and oral mucosa. A brief review of the literature is presented to help understand this uncommon finding that should be included in the differential diagnosis of spontaneous discoloration of intra-oral soft tissues.

Topics: Anti-Bacterial Agents; Diagnosis, Differential; Female; Gingiva; Humans; Melanosis; Middle Aged; Minocycline; Mouth Diseases; Mouth Mucosa; Pigmentation Disorders

Minocycline is a semisynthetic broad-spectrum antimicrobial agent that was first introduced into clinical practice in 1967. The most common use of minocycline is for the long-term treatment of acne vulgaris. A well-recognized side effect of minocycline treatment is pigmentation, which has been reported in multiple tissues and fluids including thyroid, skin, nail beds, sclera, bone, and teeth. While there have been several reports of oral pigmentation following minocycline therapy, these have been, for the most part, pigmentation of the underlying bone with the overlying oral mucosa only appearing pigmented. We report two cases of actual pigmented oral mucosal lesions on the hard palate secondary to minocycline therapy with the accompanying histopathology, followed by a discussion of minocycline-induced oral pigmentation and a differential diagnosis of these lesions.

Topics: Adult; Anti-Bacterial Agents; Diagnosis, Differential; Humans; Hyperpigmentation; Male; Melanosis; Middle Aged; Minocycline; Mouth Diseases; Mouth Mucosa; Palate, Hard

Topics: Adult; Anti-Bacterial Agents; Humans; Male; Melanosis; Minocycline; Scleroderma, Localized; Skin

Topics: Administration, Oral; Angina Pectoris; Anti-Bacterial Agents; Coronary Artery Bypass; Diagnosis, Differential; Face; Hemangiosarcoma; Humans; Male; Melanosis; Middle Aged; Minocycline; Prosthesis-Related Infections; Skin; Skin Neoplasms

Topics: Arthritis, Infectious; Arthritis, Rheumatoid; Denosumab; Drug Therapy, Combination; Female; Humans; Hyperpigmentation; Kidney Failure, Chronic; Melanosis; Middle Aged; Minocycline; Prednisone