title: Minocycline-associated intra-oral soft-tissue pigmentation: clinicopathologic correlations and review.
abstract: BACKGROUND
  Intra-oral minocycline staining of alveolar bone and teeth is well-described in the literature. Minocycline-induced discoloration of oral soft tissues is less common and has been often attributed to staining of the underlying bone.
  
  
  OBJECTIVE
  This report documents the clinical and histopathologic features of a case of actual oral soft tissue minocycline-induced pigmentation. The patient, a 45-year-old Caucasian female, presented with pigmentation of the gingiva, lips, and nail beds of recent onset. The past medical history revealed initiation of minocycline therapy 6 months earlier for dermatological concerns. Histopathologic examination of biopsy specimens from the gingiva and lip showed evidence of increased melanin/melanocytes in the epithelium and melanin/melanophages in the connective tissue. A working diagnosis of drug-associated pigmentation was determined and the patient discontinued immediately minocycline therapy. Nine months after cessation of minocycline the patient exhibited a marked reduction in pigmentation.
  
  
  CONCLUSIONS
  Systemic minocycline treatment has the potential to induce significant and esthetically objectionable discoloration of the gingiva and oral mucosa. A brief review of the literature is presented to help understand this uncommon finding that should be included in the differential diagnosis of spontaneous discoloration of intra-oral soft tissues.
authors.affiliation: Department of Periodontics, Dental School, University of Maryland, 666 W. Baltimore Street, Baltimore, MD 21201, USA.
authors.forename: Vincent N
authors.initials: VN
authors.lastname: LaPorta
authors.forename: Nikolaos G
authors.initials: NG
authors.lastname: Nikitakis
authors.forename: Arnold J
authors.initials: AJ
authors.lastname: Sindler
authors.forename: Mark A
authors.initials: MA
authors.lastname: Reynolds
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D003937:Diagnosis, Differential; D005260:Female; D005881:Gingiva / Q000187:drug effects / Q000473:pathology; D006801:Humans; D008548:Melanosis / Q000139:chemically induced; D008875:Middle Aged; D008911:Minocycline / Q000009:adverse effects*; D009059:Mouth Diseases / Q000139:chemically induced* / Q000473:pathology; D009061:Mouth Mucosa / Q000187:drug effects / Q000473:pathology; D010859:Pigmentation Disorders / Q000139:chemically induced* / Q000473:pathology
chemical_list: D000900:Anti-Bacterial Agents; D008911:Minocycline