Fraunfelder F T, Randall J A
Department of Ophthalmology, Casey Eye Institute, Oregon Health Sciences University, Portland 97201-4197, USA.
Ophthalmology. 1997 Jun;104(6):936-8. doi: 10.1016/s0161-6420(97)30204-8.
Minocycline is a commonly used drug in the management of acne and rosacea. Four individual cases of oral minocycline-induced scleral pigmentation are reported in the dermatologic literature. This is the first report in the ophthalmic literature and will add three new cases of probable minocycline-induced scleral pigmentation.
Data on minocycline from the spontaneous reporting systems of the National Registry of Drug-Induced Ocular Side Effects, Food and Drug Administration, World Health Organization, and Lederle Laboratories were reviewed as to minocycline-related scleral pigmentation. Photographs, published cases, discussions with the examining ophthalmologists, and the personal observation of one patient (case 1) are the basis of the authors' conclusions.
Seven cases of probable oral minocycline-induced scleral pigmentation are presented. These changes may or may not be associated with minocycline-induced pigmentary changes in other tissues, such as the skin, teeth, fingernails, bone, thyroid, or mucosa. The characteristic scleral pattern is a blue-gray 3- to 5-mm band starting at the limbus, which usually is enhanced in the palpebral aperture, possible due to the photosensitizing properties of the drug.
Oral minocycline can cause scleral pigmentation. This pigmentation may resolve within years, or it may be permanent.
米诺环素是治疗痤疮和酒渣鼻的常用药物。皮肤科文献报道了4例口服米诺环素引起巩膜色素沉着的个体病例。这是眼科文献中的首例报道，将新增3例可能由米诺环素引起的巩膜色素沉着病例。
对美国国家药物性眼部副作用登记处、食品药品监督管理局、世界卫生组织以及礼来实验室自发报告系统中有关米诺环素与巩膜色素沉着相关的数据进行了回顾。照片、已发表的病例、与眼科检查医生的讨论以及对1例患者（病例1）的个人观察是作者得出结论的依据。
报告了7例可能由口服米诺环素引起的巩膜色素沉着病例。这些变化可能与米诺环素引起的其他组织（如皮肤、牙齿、指甲、骨骼、甲状腺或黏膜）的色素变化有关，也可能无关。巩膜的特征性表现是从角膜缘开始出现一条3至5毫米宽的蓝灰色带，在睑裂区通常会更明显，可能是由于该药物的光敏特性。
口服米诺环素可导致巩膜色素沉着。这种色素沉着可能在数年内消退，也可能是永久性的。
