Respiratory physician Lutz Beckert considers chronic obstructive pulmonary disease management, including the prevention of COPD, the importance of smoking cessation and pulmonary rehabilitation, and the lifesaving potential of addressing treatable traits. He also discusses the logic of inhaler therapy, moving from single therapy to dual and triple therapy when indicated, as well as other aspects of management
Dark skin, blue nails – could minocycline be the cause?
Dark skin, blue nails – could minocycline be the cause?

This article discusses a case of minocycline-induced facial hyperpigmentation with later nail involvement
Kia ora and welcome to New Zealand Doctor Rata Aotearoa
Not a subscriber? Unlock this article by subscribing here.
1. Martins AM, Marto JM, Johnson JL, Graber EM. A review of systemic minocycline side effects and topical minocycline as a safer alternative for treating acne and rosacea. Antibiotics (Basel) 2021;10(7):757.
2. Eisen D, Hakim MD. Minocycline-induced pigmentation. Incidence, prevention and management. Drug Saf 1998;18(6):431–40.
3. Shute L, Walkty A, Embil JM. Minocycline-induced cutaneous hyperpigmentation. CMAJ 2020;192(34):E981.
4. Ahmad Y, Boutros H, Hanna K. Out of the blue: A case of blue subungual discoloration associated with prolonged tetracycline use. Cureus 2020;12(4):e7810.
5. Varghese K, Dykstra J, Bisbee E. Minocycline-induced hyperpigmentation of nails. Cureus 2023;15(5):e38640.
6. Ricardo JW, Shah K, Minkis K, Lipner SR. Blue skin, nail, and scleral pigmentation associated with minocycline. Case Rep Dermatol 2022;14(2):239–42.
7. Adib F, Wong J, Loftu R. Blue nails: a case of minocycline-induced hyperpigmentation. World Allergy Organization Journal 2020;13(8):100255.
8. Dalby C. A man with blue-grey nails. Aust J Gen Pract 2021;50(3):148–50.
9. Sujaya SN, Ranganath VS, Girish BS, et al. Topical minocycline induced bluish black hyperpigmentation in acne vulgaris patient: The first case report of topical application. JDDT 2024;14(4):4–6.
10. Wang RF, Ko D, Friedman BJ, et al. Disorders of hyperpigmentation. Part I. Pathogenesis and clinical features of common pigmentary disorders. J Am Acad Dermatol 2023;88(2):271–88.