Slate grey pigmentation due to minocycline therapy

We describe a 77-year-old man who attended our department for investigations of sideropenia who incidentally was noted to have patches of slate grey skin pigmentation. The patient had been treated for folliculitis affecting his scalp for several years with minocycline. Appearances were suggestive of minocycline-induced pigmentation. We discuss the incidence, pathogenesis, clinical appearances and treatment of minocycline-induced pigmentation and suggest that in most instances of skin infections the use of tetracyclines is preferable.