[Minocycline].
Minocycline belongs to the second generation class of cyclines. It was synthesized in 1967 and marketed in 1972. Minocycline has an antiinfectious activity with a spectrum similar to that of other cyclines, notably against Chlamydias, Treonema and Proprionibacterium acenes. The antiinflammatory activity is associated with this antiinfectious action is greater than that of first generation cyclines with specifically a modulator effect on epidermal cytokines. The pharmokinetics of minocycline is characterized by an excellent absorption, a long half-life and an important lipophilic property inducing good tissue distribution. Clinical trials of minocycline have mainly been performed in sexually transmissible diseases and in acne, a field where randomized studies are the most frequent. These trials show that the effect of minocycline is not stronger than first generation cyclines or doxycycline, but that the action is quicker than that of tetracycline at the dose of 500 mg a day. Minocycline is also efficient in nocardiasis, mycobacteriosis, leprosy, Lyme disease, pyoderma gangrenosum, autoimmune bullous dermatitis, Carteaud disease, and prurigo. However, the effect of minocycline in these different conditions has always been evaluated in open trials with a small number of patients. The usual side effects of cyclines, i.e. digestive problems, fungal infections, are less frequent than with first generation cyclines. No photosensitivity has been demonstrated although pigmentations have been described. Dizziness is a specific side effect of minocycline. Furthermore, rare but severe side effects have been reported, including hypersensitivity syndrome, autoimmune hepatitis, and lupus. Regular indications for minocycline in dermatology are acne and three sexually transmissible diseases (mycoplasm, chlamydia, treponema). Proposed dosage is 100 mg per day in sexually transmissible disease with a reduction to 50 mg per day after 15 days in acne.
Bernier
C
C
Clinique Dermatologique, Hôtel-Dieu, Place Alexis Ricordeau, 44093 Nantes Cedex 1.
Dréno
B
B
D000152:Acne Vulgaris / Q000188:drug therapy; D000900:Anti-Bacterial Agents / Q000145:classification / Q000494:pharmacology / Q000627:therapeutic use; D001327:Autoimmune Diseases / Q000188:drug therapy; D016207:Cytokines / Q000187:drug effects; D004334:Drug Administration Schedule; D006801:Humans; D007918:Leprosy / Q000188:drug therapy; D008193:Lyme Disease / Q000188:drug therapy; D008911:Minocycline / Q000145:classification / Q000494:pharmacology / Q000627:therapeutic use; D009164:Mycobacterium Infections / Q000188:drug therapy; D009617:Nocardia Infections / Q000188:drug therapy; D011536:Prurigo / Q000188:drug therapy; D017511:Pyoderma Gangrenosum / Q000188:drug therapy; D012107:Research Design / Q000592:standards; D012749:Sexually Transmitted Diseases / Q000188:drug therapy; D012872:Skin Diseases, Vesiculobullous / Q000188:drug therapy; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D016207:Cytokines; D008911:Minocycline