Weather 
Willy Wonka’s Violet Beauregarde could start a support group.
According to a case report in the New England Journal of Medicine, a 68-year-old woman developed “blue-gray hyperpigmentation” on her limbs just a couple of weeks after she started taking a common medication.
The woman sought treatment after dark patches on her arms and legs persisted for six weeks.
The woman suffers from rosacea, a common skin condition that causes the face to appear red or flushed — and wasn’t the cause of the blue hue.
“Rosacea is a chronic inflammatory condition in which the skin appears inflamed along with evidence of acne-like bumps and textural change,” dermatologist Alicia Zalka previously told The Post.
“Because the condition is multifaceted and is the result of the interplay of genetics, environment, vascular inflammatory responses of the skin, and even skin mites, there is no single cause of rosacea and similarly no single treatment,” she continued.
To treat it, she began taking 100 mg daily of oral minocycline two weeks prior.
According to the Mayo Clinic, minocycline, a tetracycline antibiotic that kills bacteria or prevents their growth, is commonly prescribed to treat the acne-like bumps associated with rosacea.
The drug — which is sold under brand names including Dynacin, Minocin and Solodyn — is widely prescribed to fight several conditions including acne and bacterial infections, like those that cause pneumonia.
A recent study found that it may also be helpful in treating panic disorder in patients who don’t respond to psychiatric medications, including benzodiazepines like clonazepam.
Minocycline’s side effects include dizziness, GI issues like nausea, headache, fatigue and skin sensitivity.
But hyperpigmentation — which can cause the skin to turn blue-grey or blue-black — is rare, impacting only affects 3-15% of patients. And it typically develops over months of treatment, not weeks.
For this woman, the dark patches were initially isolated to her legs and described as “asymptomatic.”
It ultimately presented on her forearms and the sides of her tongue as well, leading to a diagnosis of “minocycline-induced hyperpigmentation.”
Medical staff urged the woman to stop taking the medication and avoid sun exposure. After six months, the hyperpigmentation had “abated somewhat” but had not faded completely.
While the woman was diagnosed with Type II minocycline-induced hyperpigmentation, in which the skin turns blue or gray, there are three additional types.
For patients with Type I, blue-black spots appear in scar tissue, for those with Type III, muddy brown spots develop in areas of the skin exposed to sunlight, and for those with Type IV, these muddy brown spots appear in scar tissue.
Experts maintain that patients should be warned of the risk of these skin changes, which can necessitate laser treatments to remove.
In addition to the hyperpigmentation described above, minocycline can cause other serious skin reactions, including erythema multiforme and Stevens-Johnson syndrome (SJS), a rare disorder that begins with flu-like symptoms followed by a rash that blisters and spreads.
The condition is fatal in 10% of patients.
Minocycline has been used in humans for more than 50 years and is generally considered safe.
