To the Editor.—
In an excellent article entitled "Effect of antibiotics on the lipases of Corynebacterium acnes in Vitro," Puhvel and Reisner1 report that the tetracyclines inhibit in a concentration-dependent manner the lipases produced by that organism. They conclude, however, that this mechanism does not contribute to the clinical efficacy of the tetracyclines because the minimum level of the antibiotic they found to inhibit the lipases (25μg/ml) is not obtained in the skin by the usual acne therapy schedule. In preparation of a manuscript which appeared in the same issue,2 we came across reports which indicate that the tetracycline level in inflamed skin is several-fold greater than in the serum or normal skin.3In another publication,4 the tetracycline level found in the inflamed skin of a patient with photosensitivity was 24μg/ml of tissue, whereas the serum level was only 2.2μg/ml./ml. It has been shown that tetracycline
Jones HE. Tetracyclines in the Treatment of Acne. Arch Dermatol. 1972;106(6):923. doi:10.1001/archderm.1972.01620150097031
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