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Intralesional Lipolysis With Phosphatidylcholine for the Treatment of Lipomas: Pilot Study

Daisy Kopera, MD; Barbara Binder, MD; Hermann Toplak, MD
Arch Dermatol. 2006;142(3):393-403. doi:10.1001/archderm.142.3.395.
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In 2001, a report on intralesional injection of phosphatidylcholine for the reduction of protuberant lower eyelid fat suggested that fat could be dissolved by this substance. Subsequently, physicians used phosphatidylcholine as a “fat burner” to reduce saddlebag trochanteric bulges (breeches) and pendulous abdomens.1 To prove the ability of phosphatidylcholine to reduce fat, a pilot study for the treatment of lipomas was designed (Table). It was conducted according to good clinical practice guidelines with ethics committee approval. Fifteen volunteers (5 women and 10 men) aged 21 to 64 years (median age, 43.5 years) with 19 lipomas in various body sites were recruited for the study. All sought treatment for functional or aesthetic reasons. At baseline, before the first treatment, and at the end of follow-up (week 12), photographic documentation was performed and ultrasound imaging was used to evaluate 3 dimensions of each lipoma: thickness, length, and diameter at a 90° angle to the length, and their volume was calculated as ellipsoids (v = a:2×b:2×c:2×π×4:3).

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Ultrasound images of a lipoma before (A) and after (B) 3 intralesional applications of phosphatidylcholine. The higher echographic density in the follow-up ultrasound image represents fibrosis of the lipoma. Note that the a and b axes in part A are reversed in part B.

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