Black bone disease of the foot. Minocycline related pigmentation.

Black bone disease is a rare manifestation of long term treatment with tetracyclines. We report the case of a patient who underwent surgery for bilateral hallux valgus and was found to have black discolouration of both first rays. This was subsequently related to previous long term Minocycline use. The unique features of this case relate to the location of the discolouration and the normal physical properties of the bone and soft tissues at surgery despite heavy pigmentation. Healing is now complete and follow-up at two years confirmed excellent clinical and radiological outcomes.