Familial progressive hyperpigmentation: a family study in China.
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Two sisters are described who developed facial pigmentation while on minocycline therapy for acne vulgaris. It is suggested that the possible mechanisms for this relatively uncommon complication occurring in these two patients may be due to either a genetically acquired alteration in metabolic handling of minocycline or to the ethinyloestradiol component of Dianette, which they were also receiving as treatment for their acne vulgaris. It is concluded that patients on minocycline should be regularly screened for signs of hyperpigmentation, especially if they are on other drugs which are known to accentuate pigmentation of skin.
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The technique known as autologous minigrafting is reviewed. This procedure has proven useful and reliable for repigmenting diverse types of leukoderma. A few refinements of this technique are described. These refinements were used in six patients who were successfully repigmented. Causes of pigment loss in these cases included thermal burns, contact with monobenzyl ether of hydroquinone, chronic discoid lupus erythematosus, and segmental vitiligo.
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Incontinentia pigmenti is characterized by swirled hyperpigmentation associated with incontinence of pigment. A different pattern may be seen on the legs with light-colored atrophic scarred areas admixed with patches of normal but darker skin. Histologic examination confirms that the darker skin is normal without incontinence of pigment, while the light-colored skin lacks melanocytes and appendages but has dermal fibrosis.