Rosacea antibiotic linked to blue-gray skin patches: a minocycline side effect

A 68-year-old woman developed blue-gray patches on her arms, legs, and tongue within about two weeks of starting the rosacea antibiotic minocycline. Doctors diagnosed type II minocycline-induced hyperpigmentation, a known pigment-related side effect where drug metabolites bind iron and accumulate in macrophages, sometimes lasting after the drug is stopped. She stopped taking the medication and avoided sun exposure, and the patches faded somewhat over six months but persisted in places.