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August 1976

On the Treatment of Panniculitis With Tetracycline

Arch Dermatol. 1976;112(8):1176. doi:10.1001/archderm.1976.01630320074027

To the Editor.—  The relation between "panniculitis," whether localized or generalized, with or without associated pancreatic disease, and lipases has been thought probable for some time. In those reported cases with associated pancreatic diseases, distant foci of subcutaneous fat necrosis and inflammation were attributed to the action of hematogenous-borne lipases.1 That panniculitis is in fact due to the local action of lipase (in conjunction with trypsin and amylase) was elegantly demonstrated in a recent case report by Förström and Winklemann.2 Their patient had an acute, widespread panniculitis. Skin specimens from the lesions showed considerable lipase and amylase activity, as compared with specimens from controls. Autopsy, however, revealed a normal pancreas. Whatever the initiating factors, lipases are likely to play an important role in the pathogenesis of fat necrosis and the subsequent inflammatory reaction of panniculitis.What is the relationship between tetracycline and lipases? In connection with work on