title: Lipolysis of lipomas in patients with familial multiple lipomatosis: an ultrasonography-controlled trial.
abstract: BACKGROUND
  Surgery of multiple lipomas, as in patients with familial multiple lipomatosis, is often limited by poor aesthetic outcome owing to extensive scarring. For this reason, phosphatidylcholine (PDC) has been widely used to treat areas of localized fat accumulation. However, no reports of lipoma therapy with intralesional application of PDC, that is, injection lipolysis, have been published to date.
  
  
  OBJECTIVE
  To investigate whether injection lipolysis with PDC is an effective therapeutic option for patients with multiple lipomas.
  
  
  METHODS
  Thirty lipomas in 10 patients were sonographically measured prior to treatment. Four injections at intervals of 6 to 8 weeks were done. Sonographic measurements of lipoma size were repeated before each injection. Side effects, a pain score using a visual analogue scale, and patient satisfaction were noted. In one lipoma, histologic changes after lipolysis are described.
  
  
  RESULTS
  After four injections, a significant reduction in size of 45.8% was achieved. No complete elimination was seen in any lipoma. Histology showed a mild granulomatous septal panniculitis. Hematoma occurred in eight cases (27%). Four patients described pain on pressure for 3 days after injection. No severe side effects or systemic reactions were observed.
  
  
  CONCLUSIONS
  Although surgery is the gold standard for lipoma therapy, injection lipolysis with PDC can also significantly reduce lipoma size. Complete elimination was not observed in any lipoma. Given that this was a short-term study, long-lasting therapeutic effects and possible recurrence of lipoma cannot be evaluated.
authors.affiliation: Department of Dermatology and Allergology, Ruhr-University Bochum, Germany. f.bechara@derma.de
authors.forename: Falk Georges
authors.initials: FG
authors.lastname: Bechara
authors.forename: Michael
authors.initials: M
authors.lastname: Sand
authors.forename: Daniel
authors.initials: D
authors.lastname: Sand
authors.forename: Sebastian
authors.initials: S
authors.lastname: Rotterdam
authors.forename: Markus
authors.initials: M
authors.lastname: Stücker
authors.forename: Peter
authors.initials: P
authors.lastname: Altmeyer
authors.forename: Klaus
authors.initials: K
authors.lastname: Hoffmann
mesh_terms: D000328:Adult; D002921:Cicatrix / Q000517:prevention & control; D005260:Female; D006801:Humans; D015552:Injections, Intralesional; D008066:Lipolysis / Q000187:drug effects*; D008067:Lipoma / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D008069:Lipomatosis, Multiple Symmetrical / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010713:Phosphatidylcholines / Q000008:administration & dosage / Q000627:therapeutic use*; D014463:Ultrasonography
chemical_list: D010713:Phosphatidylcholines