Minocycline, a semisynthetic tetracycline derivative, has gained popularity as a treatment for acne vulgaris and rosacea. With this increased usage have come reports of severe and, in some cases, life-threatening toxicities, often occurring in otherwise healthy adolescents after prolonged courses of minocycline. A 15-year-old girl who was treated for 9 months with minocycline for acne vulgaris developed polyarteritis nodosa (PAN) as evidenced by livedo reticularis, diffuse myalgias and arthralgias, and skin biopsy-proven small and medium-sized vasculitis. On withdrawal of the minocycline and initiation of a slow prednisone taper, her disease resolved fully within 3 months. PAN associated with minocycline treatment has not been reported previously.

	CASE REPORT

A 15-year-old adolescent was referred with a 4-week history of an acute illness characterized by intermittent spiking fevers to 102°F; generalized myalgias and arthralgias; malaise; fever; anorexia; cervical lymphadenopathy; and an asymptomatic, progressively spreading, reticulated rash. The rash developed initially on her abdomen, but subsequently spread to involve the chest and the upper and lower extremities. She previously had been in good health, and there was no report of similar findings among family members. Nine months before the onset of her symptoms and rash, she had been placed on minocycline (50 to 100 mg twice daily) for treatment of acne vulgaris. . . . [Full Text of this Article]