Research progress of minocycline?induced skin hyperpigmentation
Department of Pharmacy, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China; Department of Pharmacy, Shanghe People′s Hospital, Shandong Province, Shanghe 251600, China; Department of Pharmacy, Shandong Provincial Hospital （group） Ludong Hospital, Shandong Province, Yantai 246000, China
Abstract：Minocycline is a semi-synthetic tetracycline antibiotic. In recent years, minocycline has been used in the treatment of chronic infections caused by multi-drug resistant bacteria and chronic diseases such as pemphigus and rheumatoid arthritis due to its lower incidence of bacterial resistance and good antibacterial effect. Long term use of oral minocycline can cause skin hyperpigmentation. According to the location, clinical features, and histopathological changes, minocycline-induced skin hyperpigmentation (MISH) is divided into 4 subtypes, but the definition of subtype 4 remains controversial. The incidence of MISH varies greatly in different studies, which may be closely related to factors such as patients′ underlying pathophysiological status, comorbid diseases, dose, and duration of treatment. For those patients who need to take minocycline for a long time, skin color should be observed. Once skin color changes were found, relevant examinations (e.g. skin biopsy) should be carried out in time to make a definite diagnosis as soon as possible. Patients with MISH should pay attention to sun protection. Reducing the dose or stopping minocycline is an effective strategy to improve MISH. Q-switched laser or picosecond laser is recommended to treat pigmentation which can not be recovered after drug withdrawal.
