Lipolysis of lipomas in patients with familial multiple lipomatosis: an ultrasonography-controlled trial.
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.
Bechara
Falk Georges
FG
Department of Dermatology and Allergology, Ruhr-University Bochum, Germany. f.bechara@derma.de
Sand
Michael
M
Sand
Daniel
D
Rotterdam
Sebastian
S
Stücker
Markus
M
Altmeyer
Peter
P
Hoffmann
Klaus
K
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
D010713:Phosphatidylcholines