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PubMedDate not supplied

Skin discoloration with blue food coloring.

OBJECTIVE: To describe a pediatric patient who developed a clinical cyanotic appearance after receiving an excessive amount of blue food coloring. CASE SUMMARY: An 11-year-old white girl with cerebral palsy was admitted for unresolving aspiration pneumonia and dehydration. Antibiotics and intravenous fluids were administered. During the hospital course, enteral nutrition containing blue food coloring was also administered. Twelve hours after the start of enteral nutrition, the patient appeared cyanotic despite a regular respiratory rate and normal oxygen saturation. The pediatric code response team was called. Enteral nutrition was stopped and then restarted without blue food coloring. Over the next 24 hours, the cyanotic appearance resolved and no further complications developed. DISCUSSION: At our institution, blue food coloring is used with enteral nutrition for detecting aspiration of stomach contents. The dietary department supplies food coloring to each nursing unit in pint-sized medicine bottles. Nurses place an unstandardized amount of blue food coloring into each enteral nutrition bag. This child received an unspecified amount of FD&C Blue No. 1 food coloring. No toxicity studies exist for acute or human ingestion, but the National Academy of Sciences lists 363 mg/d of FD&C Blue No. 1 as a safe level for humans. We estimated this child ingested 780-3,940 mg of dye over a 12-hour period. CONCLUSIONS: This is the first known report of an adverse effect from blue food coloring. To prevent similar occurrences within our institution, the blue food coloring for tube feedings will be dispensed by the pharmacy department in standardized units.

Child↗
PubMed1998

Minocycline-induced pigmentation. Incidence, prevention and management.

Pigmentation is a well recognised adverse effect of minocycline therapy. Various body sites, most notably the skin, nails, bones, thyroid, mouth and eyes are affected and the pigmentation may appear at multiple sites. In general, pigmentation results from long term administration of minocycline at cumulative doses greater than 100 g, although cutaneous or oral mucosal pigmentation may appear, regardless of dose or duration of therapy. When the skin is involved, the blue-black pigmentation develops most frequently on the shins, ankles and arms. Other patterns of skin involvement include pigmentation that is either generalised and symmetrical, or that develops at sites of inflammation. The bones of the oral cavity are probably the most frequently affected sites of pigmentation affecting greater than 20% of patients taking minocycline for more than 4 years. In contrast, the oral mucous membranes and teeth are infrequently pigmented from minocycline. Ocular, thyroid and visceral pigmentation is also relatively uncommon and usually develops only with high doses and long term minocycline use. Whereas pigmentation of the skin and oral mucosa is generally reversible when the drug is discontinued, the pigmentation is often permanent when other sites are involved. Although minocycline-induced pigmentation is not harmful, the drug should be discontinued when the adverse effect is recognised. All patients receiving minocycline, especially those treated for longer than 1 year, require screening for the development of pigmentation.

Anti-Bacterial Agents↗
PubMed1990

Hypomelanosis of Ito (incontinentia pigmenti achromians). Ophthalmological evidence for somatic mosaicism.

The authors report on a ten-year-old boy with hypomelanosis of Ito. He suffered from epileptic seizures and exhibited typical generalized partial skin hypomelanosis in whorl-like and striated pattern following Blaschko's lines. The fundi showed patchy, mottled hypopigmentations becoming increasingly striated in the periphery with a general orientation to the optic nerve head. This pattern of affection reminds of the retinal findings in carrier women for X-linked ocular albinism. Magnetic resonance imaging revealed multiple small areas of increased relaxation time scattered in the white matter of the brain, which are interpreted as porencephalic cysts. These clinical findings suggest somatic cell mosaicism even though the cytogenetic study was not conclusive.

Brain Diseases↗
PubMedDate not supplied

[Pigmented pemphigoid].

BACKGROUND: Pigmented bullous pemphigoid has many clinical manifestations. We report a pigmented erythematous form with disseminated bullae. CASE REPORT: A 70-year-old woman with a history of breast adenocarcinoma developed an eruption of pigmented macules on the trunk and members of 72 hour duration. At five days, there was an eruption of tight bullae. The diagnosis of bullous pemphigoid was retained because of the association of infraepidermic bullae, linear deposits of C3 along the basal membrane and the presence of the 180 kDa minor bullous pemphigoid antigen on immunoblotting. DISCUSSION: The initial pigmented aspect of this bullous pemphigoid suggested disseminated pigmented bullous erythema, but histology data with immunotransfer corrected the diagnosis. This very atypical presentation led us to look for a particular etiology. There was no argument in favor of a malignancy in this patient in complete remission after treatment of her breast adenocarcinoma. The fact that the patient was phototype IV would probably explain the pigmented nature of the initial lesions.

Aged↗
PubMed2002

[Motor proteins and pigmentation].

One essential part of the process of skin pigmentation comprises the production of melanosomes, the melanin-containing organelles, and correct transport towards their target cells, the keratinocytes. In this overview the molecular mechanisms of these processes are discussed in view of a number of pigmentation syndromes.

Biological Transport, Active↗