Minocycline‐related cutaneous hyperpigmentation as demonstrated by light microscopy, electron microscopy and X‐ray energy spectroscopy*

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Argenyi ZB, Finelli L, Bergfeld WF, Tuthill RJ, McMahon JT, Ratz JL, Pefroff N. Minocycline‐related cutaneous hyper‐pigmentation as demonstrated by light microscopy, electron microscopy and X‐ray energy spectroscopy. A 70‐year‐old patient with a chronic cutaneous ulcer treated by minocyclinc hydrochloride developed hyperpigmentation of the forearms. Biopsy material was studied by light microscopy, electron microscopy and X‐ray energy spectroscopy. Granular gold‐brown pigment was found in dermal histiocytes and eccrine myoepithelial cells, which gave positive reaction with Prussian blue and Fontana‐Masson stains. Electron microscopy revealed intracytoplasmic granules of dark, homogeneous material and small fine particles. X‐ray energy spectroscopy showed iron and other elements in smaller amounts. The different types of minocycline‐related hyperpigmentation and the possible patho‐mechanism are discussed with special regard to the importance of the diagnostic methods.