In 1935 Midana and del Grande1 found that extensive inflammation of the skin occurred together with higher levels of ketone bodies in the blood. Not only was the ketonemia found to be greater when ordinary diets were ingested, but ketogenic diets caused more of an increase if a dermatitis was present. Those authors expressed the belief that the inflammation of the skin gave rise to the ketones and that these could not be considered an active causative factor. The skin serves as a storage center for large quantities of glycogen. Midana and del Grande expressed the belief that at the site of inflammation in the skin there is either a lack of normal quantities of available glycogen or interference with its use, causing an incomplete burning of the fats with resultant accumulation of intermediate fat metabolites, the ketone bodies.
Simultaneously, impelled by a different purpose and utilizing another technic,
CORNBLEET T, KLEIN RI. EFFECT OF INFLAMMATION OF THE SKIN ON URINARY EXCRETION OF KETONES. Arch Derm Syphilol. 1937;36(5):1078–1080. doi:10.1001/archderm.1937.01480050144021
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