[rosacea] Information on use of Minocycline

I was surfing around Medscape and noticed this article about
Minocycline.  I don't want to alarm anyone, but if you take it please
read this.

Southern Medical Journal 
Necrotizing Vasculitis of the Skin and Uterine Cervix Associated With
Minocycline Therapy for Acne Vulgaris
Barbara J. Schrodt, MD, Carol L. Kulp-Shorten, MD, Jeffrey P. Callen,
MD, Division of Dermatology, Department of Medicine, University of
Louisville, Louisville, Ky.

Abstract

In recent years, minocycline has become a commonly used agent for the
treatment of acne vulgaris and rosacea. With this increased use have
come reports of severe and in some cases life-threatening toxicity,
often occurring in otherwise healthy young women after prolonged
courses of minocycline. These adverse reactions include hepatotoxicity,
drug-induced lupus erythematosus, eosinophilic pneumonitis, and
hypersensitivity syndrome. We describe a 35-year-old woman who had
necrotizing vasculitis of the skin and uterine cervix after 2 years of
minocycline therapy for acne vulgaris. Skin and cervical biopsies
revealed acute inflammation involving through-and-through necrosis of
vessel walls with thrombosis, focal fibrinoid change, and a
perivascular lymphohistiocytic infiltrate. The disease fully resolved
within 3 months of discontinuance of the minocycline therapy. Patients
should be informed of these rare but potentially serious adverse
effects before the initiation of minocycline therapy. Early recognition
of these complications can result in complete resolution. [South Med J
92(5):502-504, 1999. © 1999 Southern Medical Association]

Introduction

Minocycline, a semisynthetic tetracycline derivative, has gained
increased popularity as a treatment for acne vulgaris and rosacea.[1-3]
Recently, reports of rare but often severe or even life-threatening
toxic effects have included hepatotoxicity,[4-10] drug-induced lupus
erythematosus (DIL),[5,6,9-13] eosinophilic pneumonitis,[14-16]
hypersensitivity syndrome,[6,17,18] and a serum sickness-like
reaction.[6,19] In many instances, the use of minocycline was for a
chronic, non-life-threatening disease. In the following case, a patient
who was treated for 2 years with minocycline for acne vulgaris had
necrotizing vasculitis of the skin and uterine cervix. The disease
resolved fully within 3 months after withdrawal of the minocycline.
Vasculitis associated with minocycline has not been previously reported.

Reprint requests to Jeffrey P. Callen, MD, University of Louisville,
Division of Dermatology, 310 E Broadway, Louisville, KY 40202.