Background: Drug-induced hypersensitivity syndrome is an uncommon drug reaction typically manifested by severe skin lesions, fever, nodal enlargement, blood eosinophilia and hepatitis.
Case report: A 16-year-old female patient with acne was treated with minocycline 100 mg/d for one month. She developed a hypersensitivity syndrome with a generalized pustulous eruption. Prick tests with minocycline diluted in vaseline were positive at 48 hours.
Discussion: This case of minocycline-induced hypersensitivity illustrates that prick tests performed late after the initial event can reproduce the initial lesions. The causal role of several drugs, particularly anticonvulsants, has been demonstrated in drug-induced hypersensitivity syndrome. Several recent publications have implicated minocycline. Although such cases are uncommon, it would appear that cyclines, particularly minocycline, are the main cause of conditions such as drug-induced hypersensitivity syndrome, acute systemic lupus erythematosus, pulmonary eosinophil infiltration, and pseudo-serum sickness. Such secondary effects must be recognized. Patients should be advised to discontinue treatment and consult if signs such as fever, node enlargement, joint pain, or skin reactions reappear. It may be useful to perform prick tests with minocycline 4 to 6 weeks after an initial eruption.