Nail Pigmentation May Be an Early Sign of Minocycline-Associated Cutaneous Pigmentation: A Systematic Review

    August 2024 in “ Journal of the American Academy of Dermatology ”
    Eden Axler, Shilpa Malik, Angela Lu, Sung‐Min Hong, Amar D. Desai, Sofia Malik, Shari R. Lipner
    TLDR Nail color change might be an early sign of skin pigmentation from minocycline.
    This systematic review analyzed 98 studies involving 266 patients to investigate minocycline-associated pigmentation, revealing that nail pigmentation may be an early indicator of more widespread cutaneous pigmentation. The average onset of pigmentation occurred at approximately 1 year or a cumulative dose of 120 g of minocycline. Nail pigmentation alone was found to occur at significantly lower cumulative doses compared to combined skin and nail pigmentation. The review suggests limiting minocycline use to 3-4 months, monitoring cumulative doses, and conducting regular nail inspections, recommending discontinuation of the drug upon the first signs of nail pigmentation. Limitations include small sample sizes and study heterogeneity.
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