Acute, generalized panniculitis with amylase and lipase in skin

A patient had an unusual acute, generalized panniculitis. The patient had a five-fold elevation of urinary amylase level and a slightly elevated serum lipase leval without any signs or symptoms of pancreatic disease. A secretin test caused an eightfold elevation in urinary amylase level and some elevation of serum lipase and amylase levels, whereas study of duodenal drainage revealed no abnormalities. Skin specimens from the lesions showed considerable amylase and lipase activity, whereas specimens from controls and from subsequent patients with panniculitis showed no such abnormalities. Autopsy showed a normal pancreas, both grossly and microscopically.