minocycline and Psoriasis

Topics: Acneiform Eruptions; Adrenal Cortex Hormones; Antibodies, Monoclonal; Dose-Response Relationship, Drug; Drug Administration Schedule; Follow-Up Studies; Humans; Infliximab; Male; Minocycline; Psoriasis; Risk Assessment; Spondylitis, Ankylosing; Treatment Outcome; Young Adult

Tumor necrosis factor α antagonists are potent biologics used to treat a variety of autoimmune disorders such as rheumatoid arthritis, ankylosing spondylitis, Crohn disease, psoriasis, and psoriatic arthritis. These medications are known to have many side effects (eg, infusion reactions, cytopenia, risk for infection, heart failure); however, only a few cases of acne vulgaris have been associated with the use of these biologics, particularly infliximab and adalimumab. We report a rare case of etanercept-induced cystic acne.

Topics: Acne Vulgaris; Adult; Anti-Bacterial Agents; Dermatologic Agents; Etanercept; Humans; Immunoglobulin G; Male; Minocycline; Psoriasis; Receptors, Tumor Necrosis Factor; Treatment Outcome

Vitamin D research is discussed in light of the hypothesis that the lower average levels of vitamin D frequently observed in autoimmune disease are not a sign of deficiency. Instead, it is proposed that the lower levels result from chronic infection with intracellular bacteria that dysregulate vitamin D metabolism by causing vitamin D receptor (VDR) dysfunction within phagocytes. The VDR dysfunction causes a decline in innate immune function that causes susceptibility to additional infections that contribute to disease progression. Evidence has been accumulating that indicates that a number of autoimmune diseases can be reversed by gradually restoring VDR function with the VDR agonist olmesartan and subinhibitory dosages of certain bacteriostatic antibiotics. Diseases showing favorable responses to treatment so far include systemic lupus erythematosis, rheumatoid arthritis, scleroderma, sarcoidosis, Sjogren's syndrome, autoimmune thyroid disease, psoriasis, ankylosing spondylitis, Reiter's syndrome, type I and II diabetes mellitus, and uveitis. Disease reversal using this approach requires limitation of vitamin D in order to avoid contributing to dysfunction of nuclear receptors and subsequent negative consequences for immune and endocrine function. Immunopathological reactions accompanying bacterial cell death require a gradual elimination of pathogens over several years. Practical and theoretical implications are discussed, along with the compatibility of this model with current research.

Topics: Animals; Anti-Bacterial Agents; Arthritis, Reactive; Arthritis, Rheumatoid; Autoimmune Diseases; Bacterial Infections; Calcifediol; Calcitriol; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Humans; Imidazoles; Minocycline; Psoriasis; Receptors, Calcitriol; Sarcoidosis; Scleroderma, Systemic; Sjogren's Syndrome; Spondylitis, Ankylosing; Tetrazoles; Thyroid Diseases; Uveitis

Topics: Aged; Anti-Allergic Agents; Anti-Bacterial Agents; Arylsulfonates; Humans; Immunoglobulin E; Male; Minocycline; Pemphigoid, Bullous; Psoriasis; Sulfonium Compounds

A 47-year-old man who had been taking minocycline for palmoplantar pustulosis developed fever, myalgias, polyneuropathy, and testicular pain, with elevated C-reactive protein (CRP). Neither myeloperoxidase- nor proteinase-3-antineutrophil cytoplasmic antibody was positive. These manifestations met the American College of Rheumatology 1990 criteria for the classification of polyarteritis nodosa. Stopping minocycline led to amelioration of symptoms and normalization of CRP level. To our knowledge, this is the second case of minocycline-induced vasculitis satisfying the criteria. Differential diagnosis for drug-induced disease is invaluable even for patients with classical polyarteritis nodosa.

Topics: Anti-Bacterial Agents; Arthralgia; C-Reactive Protein; Humans; Male; Middle Aged; Minocycline; Paresthesia; Polyarteritis Nodosa; Psoriasis; Testis

The anti-inflammatory mechanisms of minocycline, an antibiotic used in the treatment of the inflammatory component of acne, are only partially understood. In addition to inflammation due to cytokines (IL-1, IL-6, TNF-alpha, etc.), recent studies have shown that neuropeptide-mediated neurogenic inflammation may play an important role in cutaneous inflammation. The purpose of this study was to investigate minocycline-induced modulation of cutaneous production of alpha-melanocyte-stimulating hormone (alpha-MSH), a neuropeptide with known anti-inflammatory activity. Two different skin models were used: explants of inflammatory skin and reconstituted skin, both incubated with minocycline at different concentrations and for different time periods. Epidermal production of alpha-MSH, as evaluated by immunofluorescence and immunoperoxidase techniques, showed increased expression in both models. This neuropeptide, which has an anti-inflammatory activity (notably through production of IL-10, antagonism of IL-1 and inhibition of the chemotaxis of polymorphonuclear leukocytes), thus plays a role in the anti-inflammatory action of minocycline.

Topics: alpha-MSH; Anti-Bacterial Agents; Culture Techniques; Fluorescent Antibody Technique; Humans; Keratinocytes; Minocycline; Psoriasis; Skin

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

A case of psoriatic arthritis where diagnosis was originally complicated by the presence of minocycline-induced auto-antibodies and hepatic dysfunction. The range of auto-antibodies associated with minocycline includes ds DNA and SCL 70.

Topics: Acne Vulgaris; Adult; Anti-Bacterial Agents; Arthritis, Psoriatic; Autoantibodies; Diagnosis, Differential; Female; Humans; Minocycline; Psoriasis