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Minocycline is widely used as a safe and effective therapy for acne. Between 1986 and 1994, the Committee on Safety of Medicines in Great Britain received 11 reports of suspected drug-induced lupus erythematosus and 16 reports of hepatitis associated with minocycline therapy. This paper reviews these 27 cases and describes an additional 7 cases from the authors' clinical experience.
The clinical components of the reactions suggest that one occurs early and the other occurs late. The first reaction, an "acute" hypersensitivity syndrome, occurs 1 to 3 months after the start of therapy and is characterized by fever, malaise, and hepatitis with possible rash or anemia/pancytopenia. The second reaction occurs a median of 2 years after therapy, bu…