ANSWER | Minocycline-Induced Hyperpigmentation

The correct answer is C. Increased staining on both Fontana Masson and Perls stain

Correct Answer Explanation

The patient has Type 2 minocycline-associated hyperpigmentation. Three types of minocycline-associated hyperpigmentation are generally described. The first is blue-black discoloration appearing in areas of prior skin injury, such as acne scars. The second type is a blue-gray discoloration, often on the lower anterior legs and forearms. The third type is the least common, and is characterized by muddy brown discoloration of sun-exposed areas. The first two types show staining for both iron and melanin (Fontana Masson stains melanin black; Perls stains iron [hemosiderin] blue). The third type shows increased melanin at the basal layer and within macrophages.


Abdelghany M, et al. Minocycline-induced hyperpigmentation. Cleve Clin J Med. 2016 Dec;83(12):876-877. []