Rusty green stained temporal bone associated with exposure to tetracycline: an unusual presentation of black bone disease

Severe Discoloration of the Alveolar Bone Secondary to Long-Term Minocycline Therapy: A Case Report

Minocycline, the synthetic derivative of the antibiotic tetracycline, has been used for a variety of medical treatments. One such use for minocycline is for acne vulgaris. Although widely used, minocycline has a common side effect of discoloration of tissues, including bone, skin, and mucosa. This case report presents a 19-year-old female patient with a history of long-term minocycline therapy for acne vulgaris who presented for periodontal esthetic crown lengthening. The initial exam revealed a blue-gray discoloration of the mucosa. Upon surgical exploration, it was discovered that the discoloration originated from the underlying alveolar bone with minimal gingival involvement. Surgical removal and recontouring of the bony exostoses revealed that the bone remained deeply stained. Although the discolored bone was not fully removed, the patient was able to obtain an acceptable esthetic result.

Calvarial hyperpigmentation

Background

Osseous hyperpigmentation of the calvarium is an extremely rare finding with only few reported cases in literature.

Case Description

The case is of a 59-year-old Caucasian male who presented with an acute history of generalized tonic clonic seizures and progressive weakness of the right upper limb. He had a background history of a malignant melanoma which had been resected from his left external acoustic meatus 4 weeks prior. Neuroimaging of the brain showed an intra-axial space-occupying lesion in his left parietal lobe with no associated osseous changes. A left mini parietal craniotomy was performed which revealed black discoloration of the parietal bone. The lesion was successfully resected and the bone flap was secured back in place. The patient was discharged on the 4th day postoperatively with no complications. The unusual finding of black discoloration of the calvarium was found to be secondary to adolescent tetracycline use.

Conclusion

Calvarial hyperpigmentation is a phenomenon encountered incidentally and will often come as surprise for surgeons. Once encountered, thorough history taking and examination should be done to investigate the cause.

Degradation of tetracycline by atmospheric-pressure non-thermal plasma: Enhanced performance, degradation mechanism, and toxicity evaluation

Tetracycline is a common antibiotic and is often carelessly released into the natural environment, thus constantly posing potential threats to the environment. Currently, due to lack of effective methods to remove it from the environmental water system, researchers are still exploring new ways to deal with tetracycline. In this work, we employed atmospheric-pressure non-thermal plasma (NTP) to treat tetracycline in water and investigated the involved degradation mechanism. The enhanced degradation efficiency was acquired and investigated, and the degradation mechanism by the plasma-generated active species were explored. The tetracycline degradation pathways via especially the interactions with plasma-generated hydroxyl radical and ozone were examined by virtue of UV spectroscopy, three-dimensional fluorescence spectroscopy, high performance liquid chromatography-mass spectrometry (HPLC-MS), together with the assistance of theoretical simulations. Moreover, the toxicological evaluation of NTP treatment of tetracycline was also provided, which confirmed that the biological toxicity of tetracycline degradation products was negligible. Therefore, this work provides not only the effective way of treating antibiotics by engineered plasma technology, but also the insights into the mechanisms of degradation of antibiotics by NTP.

Black Bone Disease of the Skull

We present an image of a patient's skull characterized by dark, irregular discoloration. This was discovered incidentally in a 66-year-old man who underwent craniotomy for resection of a glioblastoma. This image demonstrates cranial black bone disease. This is an abnormal bone pigmentation associated with long-term tetracycline use, as occurred in this patient.