A case of Rothmann-Makai panniculitis successfully treated with tetracycline

Clin Exp Dermatol. 2006 May;31(3):365-7. doi: 10.1111/j.1365-2230.2005.02055.x.

Abstract

Rothmann-Makai syndrome (lipogranulomatosis subcutanea) is a rare variant of Weber-Christian disease, but lacks visceral involvements and systemic manifestations. We herein report the case of a 56-year-old Chinese woman with this disorder who complained of subcutaneous tender nodules over her extremities, trunk, and face of 2 years' duration. She was firstly treated with 300 mg of oral roxythromycin for 8 weeks and subsequently treated with 400 mg of oral clarithromycin for the next 8 weeks. However, no significant effect was observed. She was then administered 200 mg of oral minocycline hydrochloride. After 1 week, her skin symptoms rapidly improved and no relapse has been observed in a follow-up period of 3 months. Considering that tetracycline antibiotics, but not macrolide antibiotics, inhibit the activity of pancreatic lipase in vitro, the efficiency of tetracycline antibiotics may be a clue to clarifying the pathogenesis of this disorder.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Arm
  • Clarithromycin / therapeutic use
  • Facial Dermatoses / drug therapy
  • Facial Dermatoses / pathology
  • Fat Necrosis / drug therapy
  • Fat Necrosis / pathology
  • Female
  • Humans
  • Leg Dermatoses / drug therapy*
  • Leg Dermatoses / pathology
  • Middle Aged
  • Minocycline / therapeutic use*
  • Panniculitis, Nodular Nonsuppurative / drug therapy*
  • Panniculitis, Nodular Nonsuppurative / pathology
  • Roxithromycin / therapeutic use
  • Tetracyclines / therapeutic use*
  • Thorax

Substances

  • Anti-Bacterial Agents
  • Tetracyclines
  • Roxithromycin
  • Minocycline
  • Clarithromycin