PMC3674755_01
Minocycline-induced hyperpigmentation.. Notes: There is increased faintly visible light brown pigment (melanin) within the basal keratinocytes (long arrow) and dermal dendocytes (short arrow). The blue pigment within the papillary dermis is the ink used for margins.
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A 0.4 x 0.3 x 0.3 cm punch biopsy demonstrated mild perivascular lymphocytic infiltrates with increased pigment deposition in the basal layers of the epidermis (Figure 1).
Iron stain.. Notes: This high power view shoes the pigment within the basal keratinocytes and dermal macrophages is negative for iron. the pigment is slightly better visualized here than routine hematoxyline and eosin in Figure 1.
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Iron stain was negative (Figure 2).
Diffuse blue-black darkening after prolonged minocycline use.. Notes: Spot-treatment trialed with 3 Q-switched lasers (Neodynium: YAG 1064 nm, Alexandrite 755 nm, and Ruby 694 nm).
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The results of the trial therapy after 1 week are shown in Figure 3.
Results after 2 sessions with the Q-switched Alexandrite (755 nm) laser.
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These treatments led to complete resolution of hyperpigmentation and the patient was completely satisfied with the result (Figure 4).