Bowen Anneli Ririe, McCalmont Timothy H
Department of Dermatology, University of Utah, Salt Lake City, Utah, USA.
J Am Acad Dermatol. 2007 Nov;57(5):836-9. doi: 10.1016/j.jaad.2007.04.028.
Hyperpigmentation associated with prolonged minocycline use is well documented. The histopathology of cutaneous minocycline pigment is characterized by deposition of brown/black, Fontana-Masson, and Perls' positive granules deposited along elastic fibers in the papillary dermis and occurring within macrophages along vessels and eccrine units in the dermis. The subcutis may also be involved; however, the specific subcutaneous findings associated with minocycline hyperpigmentation have not been well established. We present the histopathologic findings of 4 cases of minocycline hyperpigmentation with subcutaneous involvement. Green-gray, flocculent, nonrefractile globules within macrophages were found in the subcutis of all patients. Two of 4 cases exhibited lipomembraneous changes that were also associated with pigment. These distinctive findings may provide additional clues to enable a diagnosis of drug-induced hyperpigmentation to be offered, even in the absence of a clear clinical history.
长期使用米诺环素导致的色素沉着已有充分文献记载。皮肤米诺环素色素沉着的组织病理学特征为，棕色/黑色、Fontana-Masson染色阳性以及Perls染色阳性的颗粒沉积于乳头真皮层的弹性纤维周围，并存在于真皮层血管和小汗腺单位周围的巨噬细胞内。皮下组织也可能受累；然而，与米诺环素色素沉着相关的具体皮下表现尚未完全明确。我们展示了4例伴有皮下组织受累的米诺环素色素沉着病例的组织病理学发现。在所有患者的皮下组织中，巨噬细胞内均发现了绿灰色、絮状、无折光性的小球体。4例中有2例出现了与色素沉着相关的脂膜样改变。这些独特的发现可能提供额外线索，即使在缺乏明确临床病史的情况下，也有助于诊断药物性色素沉着。
