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To the Editor.—
The point brought out by Dr. Jones is well taken, that is, it has been amply demonstrated that tetracycline has the characteristic of accumulating and concentrating in areas of inflammation. Thus, it is entirely conceivable that in inflamed lesions of acne vulgaris tetracycline levels greatly exceed the figures that we quoted, as found in sebum analysis of patients on tetracycline therapy or in serum after administration of tetracycline. Our studies demonstrated that it required 30 times as much tetracycline per milliliter to produce any detectable inhibition of Corynebacterium acnes lipase activity on tributyrin in vitro, as was required for the bacteriostatic action on the most resistant C acnes strains tested in vitro. We did not presume, on the basis of our in vitro studies, to rule out the possibility that the anti-lipolytic effect of tetracycline may contribute to its efficacy in the treatment of acne. We suggested
Puhvel SM, Reisner RM. Tetracyclines in the Treatment of Acne-Reply. Arch Dermatol. 1972;106(6):923. doi:10.1001/archderm.1972.01620150097032