Minocycline‐associated intra‐oral soft‐tissue pigmentation: clinicopathologic correlations and review

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Abstract
Background:Intra‐oral minocycline staining of alveolar bone and teeth is well‐described in the literature. Minocycline‐induced discoloration of oral soft tissues is less common and has been often attributed to staining of the underlying bone.Aim:This report documents the clinical and histopathologic features of a case of actual oral soft tissue minocycline‐induced pigmentation. The patient, a 45‐year‐old Caucasian female, presented with pigmentation of the gingiva, lips, and nail beds of recent onset. The past medical history revealed initiation of minocycline therapy 6 months earlier for dermatological concerns. Histopathologic examination of biopsy specimens from the gingiva and lip showed evidence of increased melanin/melanocytes in the epithelium and melanin/melanophages in the connective tissue. A working diagnosis of drug‐associated pigmentation was determined and the patient discontinued immediately minocycline therapy. Nine months after cessation of minocycline the patient exhibited a marked reduction in pigmentation.Conclusion:Systemic minocycline treatment has the potential to induce significant and esthetically objectionable discoloration of the gingiva and oral mucosa. A brief review of the literature is presented to help understand this uncommon finding that should be included in the differential diagnosis of spontaneous discoloration of intra‐oral soft tissues.

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