Lipogranulomatosis Subcutanea (Rothmann-Makai)

A case of Rothmann-Makai panniculitis successfully treated with tetracycline

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.

Panniculitis (Rothmann-Makai), with good response to tetracycline

A case of idiopathic cirucumscribed panniculitis of the legs, with features consistent with that of the Rothmann-Makai syndrome, is reported. The response to a 10-week course of oral tetracycline therapy was impressive. It is suggested that the anti-lipase activity of tetracycline could account for this response.