Minocycline Induced Hyperpigmentation in a Rheumatoid Arthritis Population

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The Frequency and Distribution of Minocycline Induced Hyperpigmentation in a

Rheumatoid Arthritis Population

(First Release June 1 2006; J Rheumatol 2006;33:1254-7)

http://www.jrheum.com/abstracts/abstracts06/1254.html

GILLIAN ROBERTS and HILARY A. CAPELL

ABSTRACT.

Objective. Minocycline is particularly useful in patients with rheumatoid

arthritis (RA) with previous major sepsis, where anti-tumor necrosis factor

is relatively contraindicated. Pigmentation is a documented side effect, but

predisposing factors in an RA population have not been established. We

investigated minocycline induced pigmentation in a population with RA to

determine whether skin type and eye color influence predisposition to this

side effect.

Methods. Patients with RA attending a rheumatology unit who had received

minocycline were contacted by telephone and some were also interviewed in

the clinic. Those receiving therapy for more than 3 months were assessed.

Hair color, eye color, tendency to burn in the sun, and dose and duration of

therapy were documented. The frequency, type, and distribution of

pigmentation were established.

Results. Of 37 patients identified, 10 were excluded because the duration of

therapy was less than 3 months. Of the remaining 27 patients, 85% were

female, with median age 64 years (range 44-88) and median disease duration

23.5 years (range 4-51). Eleven patients (41%) developed pigmentation after

a median of 12 months. Four of the 11 stopped their minocycline due to

pigmentation. Hair color, eye color, and tendency to burn in the sun did not

predict patients who developed pigmentation.

Conclusion. Pigmentation is a common side effect in patients receiving

minocycline therapy for more than 3 months. Most patients do not stop

therapy due to pigmentation. Those who stop are more likely to be female,

less than 70 years of age, and have facial pigmentation.