Kudrna Jeremy J, Eisenbeisz H Carson, Huot Christopher
University of South Dakota Sanford School of Medicine, Rapid City, South Dakota.
Penn State College of Medicine, Department of Ophthalmology, Hershey, Pennsylvania.
S D Med. 2020 Aug;73(8):360-365.
A 71-year-old female presented to the ophthalmology clinic with bilateral brown to black pigmentary cysts in the lower palpebral conjunctiva following eight months of 100 mg twice daily oral minocycline therapy for long- standing pyoderma gangrenosum. Minocycline-induced pigmentation has been reported in skin, nails, teeth, mucosa, thyroid, bones, and sclera. To our knowledge, since 1981, only eight cases of minocycline-induced conjunctival pigmentation have been reported, all of which occurred after longer usage and higher cumulative doses of minocycline. The diagnosis could be verified by cobalt blue filter autofluorescence. Too few cases of this benign condition exist to establish management guidelines, risk stratification of minocycline dosage/length of therapy, or other contributing patient-demographic factors. In this case, minocycline discontinuation was recommended, and a two-month follow-up ophthalmologic exam revealed unchanged pigmentation.
一名71岁女性因长期坏疽性脓皮病接受每日两次、每次100毫克的米诺环素口服治疗八个月后，出现双侧下睑结膜棕色至黑色色素性囊肿，遂前往眼科门诊就诊。米诺环素引起的色素沉着已在皮肤、指甲、牙齿、黏膜、甲状腺、骨骼和巩膜中被报道。据我们所知，自1981年以来，仅报道了8例米诺环素引起的结膜色素沉着病例，所有这些病例均发生在米诺环素使用时间更长、累积剂量更高之后。通过钴蓝光滤过自体荧光可确诊。这种良性疾病的病例太少，无法制定管理指南、米诺环素剂量/治疗时长的风险分层或其他相关的患者人口统计学因素。在该病例中，建议停用米诺环素，两个月后的眼科随访检查显示色素沉着未改变。
