minocycline and Mouth-Diseases

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

Tetracyclines (TCN) were introduced in 1948 as broad-spectrum antibiotics that may be used in the treatment of many common infections in children and adults. One of the side-effects of tetracyclines is incorporation into tissues that are calcifying at the time of their administration. They have the ability to chelate calcium ions and to be incorporated into teeth, cartilage and bone, resulting in discoloration of both the primary and permanent dentitions. This permanent discoloration varies from yellow or gray to brown depending on the dose or the type of the drug received in relation to body weight. Minocycline hydrochloride, a semisynthetic derivative of tetracycline often used for the treatment of acne, has been shown to cause pigmentation of a variety of tissues including skin, thyroid, nails, sclera, teeth, conjunctiva and bone. Adult-onset tooth discoloration following long-term ingestion of tetracycline and minocycline has also been reported. The remarkable side-effect of minocycline on the oral cavity is the singular occurrence of "black bones", "black or green roots" and blue-gray to gray hue darkening of the crowns of permanent teeth. The prevalence of tetracycline and minocycline staining is 3-6%. The mechanism of minocycline staining is still unknown. Most of the reviewed literature consisted of case reports; longitudinal clinical trials are necessary to provide more information on the prevalence, severity, etiology and clinical presentation of tetracycline and TCN-derivative staining in the adult population.

Topics: Anti-Bacterial Agents; Humans; Hyperpigmentation; Minocycline; Mouth Diseases; Tetracycline; Tooth Discoloration

Minocycline is a semisynthetic tetracycline used in the treatment of inflammatory acne because of its broad spectrum of activity, less common development of resistant organisms, and its anti-inflammatory effects. A number of adverse reactions are reported, including skin and oral pigmentation. This paper details the pharmacology of minocycline and describes the pigmentation and likely mechanisms active in both hard and soft tissues. Oral pigmentation usually involves the hard tissues only and presents typically as a discrete band occupying the central zone of the alveolar mucosa and palate. As with other sites, it may persist following withdrawal of the drug. Early recognition by the dental practitioner may allow an alternative form of therapy to be sought, minimizing the likelihood of a long-term aesthetic problem.

Topics: Acne Vulgaris; Adult; Alveolar Process; Anti-Bacterial Agents; Anti-Inflammatory Agents; Esthetics, Dental; Humans; Minocycline; Mouth Diseases; Mouth Mucosa; Palate; Pigmentation Disorders; Skin Pigmentation

Minocycline is a broad-spectrum antibiotic belonging to the tetracycline family, often prescribed in infective skin conditions such as acne and rosacea. Minocycline-induced staining of the sclerae, ears, oral mucosa and teeth are rare but troublesome conditions. If patients already have concerns about their appearance due to an unsightly skin condition, careful consideration ought to be given to using minocycline as it could worsen the status quo, should potentially irreversible blue staining occur. This report describes one case and highlights some of the other dangers of long-term minocycline use which may present themselves to dentists.

Topics: Anti-Bacterial Agents; Ear Diseases; Ear, External; Female; Humans; Middle Aged; Minocycline; Mouth Diseases; Mouth Mucosa; Pigmentation Disorders; Scleral Diseases; Tooth Discoloration

Topics: Anti-Bacterial Agents; Ear Diseases; Female; Humans; Minocycline; Mouth Diseases; Pigmentation Disorders; Scleral Diseases; Tooth Discoloration

Topics: Anti-Bacterial Agents; Antimalarials; Diagnosis, Differential; Humans; Hyperpigmentation; Lupus Erythematosus, Systemic; Minocycline; Mouth Diseases; Mouth Mucosa; Palate, Hard

Topics: Acne Vulgaris; Adolescent; Anti-Bacterial Agents; Dermatologic Agents; Female; Humans; Minocycline; Mouth Diseases; Pigmentation Disorders

The aim of this study was to obtain information for an effective antimicrobial therapy against orofacial odontogenic infections; such information was obtained from recent bacteriologic features and antimicrobial susceptibility data.. The bacteriology and antimicrobial susceptibility of major pathogens in 163 patients with orofacial odontogenic infections to 7 antibiotics was examined.. Mixed infection of strict anaerobes with facultative anaerobes (especially viridans streptococci) was observed most often in dentoalveolar infections, periodontitis, and pericoronitis. Penicillin (penicillin G) was effective against almost all pathogens, although it did not work well against beta-lactamase-positive Prevotella. Cefmetazole was effective against all test pathogens. Erythromycin was ineffective against viridans streptococci and most Fusobacterium. Clindamycin exerted a strong antimicrobial activity on anaerobes. Minocycline was effective against almost all the test pathogens. The antimicrobial activity of levofloxacin against viridans streptococci was not strong.. An antibiotic that carries out antimicrobial activity against both viridans streptococci and oral anaerobes should be suitable for treatment of dentoalveolar infection, periodontitis, and pericoronitis. Penicillin remains effective as an antimicrobial against most major pathogens in orofacial odontogenic infections. Cefmetazole, clindamycin, and minocycline may be effective against most pathogens, including penicillin-unsusceptible bacteria.

Topics: Anti-Bacterial Agents; Bacteria, Anaerobic; Bacterial Infections; beta-Lactamases; Cefmetazole; Chi-Square Distribution; Clindamycin; Drug Resistance, Microbial; Erythromycin; Humans; Microbial Sensitivity Tests; Minocycline; Mouth Diseases; Penicillins; Periapical Abscess; Pericoronitis; Periodontal Abscess; Periodontitis; Prevotella; Streptococcus

Topics: Acne Vulgaris; Adult; Anti-Bacterial Agents; Female; Humans; Hyperpigmentation; Male; Minocycline; Mouth Diseases

Cicatricial pemphigoid is a rare autoimmune blistering disease of the elderly. It predominantly affects the mucosae, causing pain and scarring. the target antigen is within the lamina lucida of the basement membrane zone. Potential complications of systemic steroid and other immunosuppressive therapy have prompted trials of other means of treatment. We describe a series of seven patients treated with minocycline, six of whom derived sustained alleviation of orodynia. Four patients developed hyperpigmentation, and two complained of gastrointestinal discomfort which necessitated cessation of minocycline. Complete steroid withdrawal was achieved in two cases. Neither the disease progression nor the response to treatment was influenced by the immunoglobulin isotype or titre. The role of minocycline as a useful adjunct to therapy is discussed.

Topics: Aged; Female; Humans; Immunoglobulin A; Immunoglobulin G; Male; Middle Aged; Minocycline; Mouth; Mouth Diseases; Palate, Soft; Pemphigoid, Benign Mucous Membrane

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

Topics: Acne Vulgaris; Adolescent; Female; Humans; Minocycline; Mouth Diseases; Mouth Mucosa; Pigmentation Disorders; Tetracyclines

Pigmentation of the oral mucosa may be a sign of underlying systemic disease. An unusual case of what appeared clinically as mucosal pigmentation was shown eventually to be minocycline-related pigmentation of the underlying alveolar bone. If this manifestation of bone discoloration is recognized, unnecessary investigation may be avoided.

Topics: Adult; Alveolar Process; Diagnosis, Differential; Humans; Male; Mandibular Diseases; Minocycline; Mouth Diseases; Mouth Mucosa; Pigmentation Disorders; Tetracyclines