Black veins: a case of minocycline-induced pigmentation post-sclerotherapy and a review of literature.
Minocycline-induced pigmentation (MIP) is an uncommon but well-described adverse effect of oral minocycline treatment. MIP is clinically and histopathologically distinct from post-sclerotherapy pigmentation. We report a case of a patient presenting with blackened skin overlying veins recently treated with endovenous laser and foam sclerotherapy. The patient was a 44-year-old male with systemic sclerosis who commenced minocycline for the treatment of rosacea 5 months prior. Histological examination of the discolored tissue and underlying vein revealed hemosiderin deposition in the dermis and pigmented macrophages within the sub-endothelial layer of the vein wall with a staining pattern consistent with MIP. Venous tissue has not previously been reported in the literature as a target of minocycline pigmentation. Our patient preferred to control his rosacea by continuing to take minocycline. Follow-up ultrasound examinations revealed the treated vessels to be fully occluded with no evidence of recanalization, residual flow or ongoing thrombophlebitis. Despite a good sclerotherapy outcome, the pigmentation did not subside over 2 years. This case demonstrates that oral minocycline may induce significant and potentially long-term pigmentation in predisposed patients undergoing sclerotherapy.
Dermatology, Phlebology and Fluid Mechanics Research Laboratory, St Vincent's Centre for Applied Medical Research, Sydney, Australia.
Phoebe
P
Star
Department of Pathology, Skin and Cancer Foundation Australia, Darlinghurst, Australia.
Carolyn
C
Choy
Dermatology, Phlebology and Fluid Mechanics Research Laboratory, St Vincent's Centre for Applied Medical Research, Sydney, Australia.|Department of Dermatology, St. Vincent's Hospital, Sydney, Australia.
Kurosh
K
Parsi
D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D003872:Dermatitis / Q000628:therapy*; D006801:Humans; D053685:Laser Therapy; D008297:Male; D008911:Minocycline / Q000009:adverse effects*; D010689:Phlebitis / Q000628:therapy*; D010858:Pigmentation; D012393:Rosacea / Q000188:drug therapy*; D012595:Scleroderma, Systemic; D015911:Sclerotherapy / Q000009:adverse effects*
D000900:Anti-Bacterial Agents; D008911:Minocycline
minocycline; pigmentation; sclerotherapy; veins