A 74-year-old woman admitted with a chest infection was noted to have an extensive slate grey skin discolouration of the face and lower legs (figures 1 and 2). She had been treated with minocycline for seven years for chronic blepharitis. Figure 1Face. Figure 2Lower legs. Long term treatment with minocycline in conditions such as acne and rheumatoid arthritis may result in insoluble complex deposition in areas of previous scarring and inflammation, in a photo-sensitive distribution and in normal skin, particularly the lower legs. Variation in individual susceptibility to pigmentation and distribution may be influenced by older age, genetic factors (mechanisms not known) and concomitant medications, most notably oestrogen-containing preparations, amitriptyline, phenothiazines and isotret... read more..
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