title: Lipomas treated with subcutaneous deoxycholate injections.
abstract: BACKGROUND
  Lipomas are benign neoplasms of mature fat cells. Current treatments are invasive and carry the risk of scarring. Injections of phosphatidylcholine solubilized with deoxycholate, a bile salt, have been used to reduce unwanted accumulations of fat. Recent in vitro and ex vivo investigations indicate that deoxycholate alone causes adipocyte lysis.
  
  
  OBJECTIVE
  We sought to report our experience treating lipomas using subcutaneous deoxycholate injections.
  
  
  METHODS
  A total of 6 patients presenting with 12 lipomas were treated with intralesional injections of sodium deoxycholate (1.0%, 2.5%, and 5.0%) at intervals of 2 to 20 weeks. Tumor size, cutaneous reactions, and patients' subjective responses were recorded before and after treatment.
  
  
  RESULTS
  All lipomas decreased in size (mean area reduction, 75%; range, 37%-100%) as determined by clinical measurement (with ultrasound confirmation in one lipoma) after an average of 2.2 treatments. Several lipomas fragmented or became softer in addition to decreasing in volume. Adverse effects, including transient burning, erythema, and local swelling, were associated with higher deoxycholate concentrations but resolved without intervention. There was no clear association between deoxycholate concentration and efficacy.
  
  
  CONCLUSIONS
  Our clinical experience supports our laboratory investigations demonstrating that deoxycholate, rather than phosphatidylcholine, is the active ingredient in subcutaneously injected formulas used to treat adipose tissue. This small series suggests that low concentration deoxycholate may be a relatively safe and effective treatment for small collections of fat. However, controlled clinical trials will be necessary to substantiate these observations.
authors.affiliation: Division of Dermatology, University of California Los Angeles, David Geffen School of Medicine, Los Angeles, California, USA. arotunda@hotmail.com
authors.forename: Adam M
authors.initials: AM
authors.lastname: Rotunda
authors.forename: Glynis
authors.initials: G
authors.lastname: Ablon
authors.forename: Michael S
authors.initials: MS
authors.lastname: Kolodney
mesh_terms: D000328:Adult; D003840:Deoxycholic Acid / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007279:Injections, Subcutaneous; D008067:Lipoma / Q000188:drug therapy*; D008297:Male; D012878:Skin Neoplasms / Q000188:drug therapy*
chemical_list: D003840:Deoxycholic Acid