2 New Studies by Ruhr University Bochum and University of California, Los Angeles
The Department of Dermatology and Allergology, Ruhruniversität Bochum, and the Department of Physiological Science, University of California Los Angeles, have published 2 basic studies about the treatment of Lipomas. More information here.
1. Lipolysis of Lipomas in Patients with Familial Multiple Lipomatosis: An Ultrasonography-Controlled Trial, Falk G. Bechara, Michael Sand, Daniel Sand, S. Rotterdam, Markus Stücker, Peter Altmeyer, and Klaus Hoffmann, Journal of Cutaneous Medicine and Surgery, Vol. 10, No 4 (July/August), 2006
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.
Conclusion: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.
2. Fat tissue after lipolysis of lipomas: A histopathological and immunohistochemical study, Falk G. Bechara, Michael Sand, Klaus Hoffmann, Daniel Sand, Peter Altmeyer and Markus Stücker, Journal of Cutaneous Pathology, Volume 34 Issue 7 Page 552-557, July 2007
Background: Injections with Lipostabil®, a phosphatidylcholine (PDC) containing substance, have become a popular technique to treat localized fat accumulation and lipomas for aesthetic reasons. Despite its frequent use, the mechanism of action of PDC and histological changes of treated fat tissue still remain unclear. To investigate the histological changes of lipomas after treatment with PDC.
Methods: In all, fourteen lipomas (n = 14) in five patients presenting with multiple lipomas were treated with intralesional injections of PDC (Lipostabil®, Nettermann, Germany). Histological changes with immunohistochemical analysis of the inflammatory process were evaluated 4, 10, 24, 48 h, 10 days, 30 days and 60 days after lipolysis.
Results: Between 4 and 48 h after injection, histology shows a lobular neutrophilic infiltrate with partially destroyed fat cells. At day 10 the inflammatory process is accompanied by an infiltration of T-lymphocytes. After 60 days formation of macrophages with foam cells are visible, accompanied by thickened septa and capsula.
Conclusion: Lipolysis with PDC results in a distinct inflammatory reaction of affected fat tissue, similar to factitial panniculitis. Early destruction of fat cells may suggest the involvement of detergent or osmotic mechanisms in the process.