|LETTER TO EDITOR
|Year : 1994 | Volume
| Issue : 1 | Page : 56
Minocycline induced lingual hyperpigmentation
N Khanna, KR Pandhi
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Khanna N, Pandhi K R. Minocycline induced lingual hyperpigmentation. Indian J Dermatol Venereol Leprol 1994;60:56
To the Editor,
A 27-year-old unmarried female patient with severe acne was put on therapy with minocycline 100 mg daily. Within 3 weeks of starting therapy, she developed bluish grey hyperpigmentation on the dorsal aspect of her tongue.
There was no pigmentary change in the buccal mucosa or on the skin and there was no discoloration of the nails. Minocycline was withdrawn when the patient came for checkup at 4 weeks. She was put on alternate treatment regime for acne and followed up at regular intervals of 4 weeks. The lingual pigmantation gradually faded and at 20 weeks was barely perceptiable.
Minocycline induced hyper-pigmentation has been described in a variety of forms but is distinctly infrequent. Several hypothesis have been proposed for its pathogenesis. Minocycline is thought to stimulate melanin production by epidermal melanocytes. In addition, an Iron containing compound possibly haemosiderin or an Iron chelate of minocycline, may be deposited within the dermal macrophages. 
Although, pigmentation has been generally reported after long-term therapy with minocycline,  occasionally it has been noticed as early as 20 days after starting treatment .  In our patient too, the lingual pigmentation developed about 3 weeks after starting minocycline therapy. Pigmentation caused by minocycline is usally reversible.  This was also the case with our patient whose lingual pigmentation was barely perceptible at 20 weeks, following withdrawal of the drug.
| References|| |
|1.||Sato S, Murphy G F, Bernhard J D, et al. Ultrastructural and X-ray microanalytical observations of minocycline-related hyperpigmentation of the skin. J Invest Dermatol 1981; 77 : 264 - 7. |
|2.||Gordon G, Benjamin M S, latropousous M J. Hyperpigmentation of the skin associated with minocycline therapy. Arch Dermatol 1985; 121 : 618-23. |
|3.||Mashimo K, Kato Y, Saito R. Laboratory and clinical investigations on minocycline. Chemotherapy 1970; 18 : 339 - 46. |