Lipomas treated with subcutaneous deoxycholate injections

Rotunda, Adam M.; Ablon, Glynis; Kolodney, Michael S.

doi:10.1016/j.jaad.2005.07.068

Cited by 125 publications

(146 citation statements)

References 18 publications

(20 reference statements)

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“…Histopathological findings in the present study support the previous evidences that deoxycholate is lipolytic in its own and is the active component of PC/DC formulations that were previously postulated by Routanda et al and by Schuller-Petrovec et al [19,31,38].…”

Section: Discussionsupporting

confidence: 92%

“…On comparing the decline in circumferential measurement throughout the sessions in the PC/DC group versus the DC group, there was no significant difference between the two groups too. This means that both substances moderately reduced fat and can be considered equivalent in terms of efficacy and thus supporting the theory originally postulated by Routanda et al that deoxycholate has lipolytic activity of its own and could be the active ingredient in the PC/DC formula [19,31].…”

Section: Discussionsupporting

confidence: 83%

“…Among these are the small, well-localized deposit of subcutaneous fat where a volume of 100 to 500 ml is considered ideal especially if soft, spongy fat [18]. Other indications include lipoma or multiple lipomas, [19] and post liposuction deformities. Fat grafting if there is an area with too much "take" of the injected fat, or where the injected fat "take" unevenly is another indication for this procedure.…”

Section: Indications Of Injection Lipolysismentioning

confidence: 99%

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Evaluation of the Efficacy of Injection Lipolysis using Phosphatidylcholine/Deoxycholate Versus Deoxycholate Alone in Treatment of Localized Fat Deposits

A¹,

R²,

N³

2012

J Clin Exp Dermatol

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The practice of injection lipolysis, using drugs generally based on phosphatidylcholine and deoxycholate (PCDC), evolved from the initial intravenous use of those drug formulations to treat blood disorders. Formulations containing phosphatidylcholine and bile salts (phosphatidylcholine bile salt formulations, PBF) are increasingly being utilized to treat localized fat accumulation. Several open label clinical studies have reported promising results using injections of PBFs for the treatment of localized fat accumulation, including lower eyelid fat herniation and "buffalo hump" lipodystrophy.Bile salts have been used to improve the aqueous solubility of phosphatidylcholine. Highly purified phosphatidylcholine can be combined with the secondary bile salt sodium deoxycholate, an anti-microbial, benzyl alcohol, and water to form a stable, mixed micelle preparation that can be rapidly sterilized and used for intravenous administration . Pharmaceutical preparations of this mixture are marketed in other countries for treatment of liver disease and hyperlipidemia, respectively.Deoxycholate is used to solubilize phosphatidylcholine by forming mixed micelles composed of phosphatidylcholine and deoxycholate. It is common practice to combine intravenous medications with bile salts to improve their water solubility.These findings suggest that sodium deoxycholate is the primary active ingredient in the phosphatidylcholine preparations. These findings have been translated clinically. The effects of deoxycholate and the phosphatidylcholine formulation with deoxycholate are nonspecific, such that injection into tissue besides fat may cause necrosis.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 83%

Section: Indications Of Injection Lipolysismentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of the Efficacy of Injection Lipolysis using Phosphatidylcholine/Deoxycholate Versus Deoxycholate Alone in Treatment of Localized Fat Deposits

A¹,

R²,

N³

2012

J Clin Exp Dermatol

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“…Local injection with thyroxine [107] , enoxaparin [109] , deoxycholate [110] , and phosphatidylcholine [78] have also been proposed for treatment of lipomas but the latter require multiple injections and use of thyroxine injections in the presence of autonomic dysfunction would be dangerous. In addition, the extent of the SAT in MSL does not allow for single site injections, limiting these treatments to lipomas.…”

Section: Msl Treatment Recommendationsmentioning

confidence: 99%

Rare adipose disorders (RADs) masquerading as obesity

2012

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Rare adipose disorders (RADs) including multiple symmetric lipomatosis (MSL), lipedema and Dercum's disease (DD) may be misdiagnosed as obesity. Lifestyle changes, such as reduced caloric intake and increased physical activity are standard care for obesity. Although lifestyle changes and bariatric surgery work effectively for the obesity component of RADs, these treatments do not routinely reduce the abnormal subcutaneous adipose tissue (SAT) of RADs. RAD SAT likely results from the growth of a brown stem cell population with secondary lymphatic dysfunction in MSL, or by primary vascular and lymphatic dysfunction in lipedema and DD. People with RADs do not lose SAT from caloric limitation and increased energy expenditure alone. In order to improve recognition of RADs apart from obesity, the diagnostic criteria, histology and pathophysiology of RADs are presented and contrasted to familial partial lipodystrophies, acquired partial lipodystrophies and obesity with which they may be confused. Treatment recommendations focus on evidencebased data and include lymphatic decongestive therapy, medications and supplements that support loss of RAD SAT. Associated RAD conditions including depression, anxiety and pain will improve as healthcare providers learn to identify and adopt alternative treatment regimens for the abnormal SAT component of RADs. Effective dietary and exercise regimens are needed in RAD populations to improve quality of life and construct advanced treatment regimens for future generations.

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“…PDC was originally combined with DC in order to solubilize the formula; however, some studies have suggested that DC alone is the major contributor to lipolysis (24). Rotunda et al (25) revealed that PDC/DC treatment resulted in a slightly higher reduction in lipoma size than did DC alone, which suggests that both components contribute to the degradation of fatty tissue. When applied to lipomatous tissue, PDC/DC has yielded a decrease in lipoma size in multiple studies (26,27).…”

Section: Phosphatidyl Choline/deoxycholatementioning

confidence: 99%

A review of techniques and procedures for lipoma treatment

Boyer¹

2015

cderm

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SummaryLipomas are benign fatty tumors that may be removed for symptomatic or cosmetic reasons. Common removal techniques are limited by the risk of scarring and recurrence. The following paper provides a review of lipoma excision techniques and possible alternative technologies that have been tested or are being developed. Of the reviewed methods, liposuction is the most effective overall in removing adipose tissue, but is hindered by associated costs. Deeper lipomas may be ablated with laser technologies, although larger incisions are required. Additionally, study results of ultrasound and pharmaceutical methods are promising, but require FDA approval before becoming a prevalent practice.

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Lipomas treated with subcutaneous deoxycholate injections

Cited by 125 publications

References 18 publications

Evaluation of the Efficacy of Injection Lipolysis using Phosphatidylcholine/Deoxycholate Versus Deoxycholate Alone in Treatment of Localized Fat Deposits

Evaluation of the Efficacy of Injection Lipolysis using Phosphatidylcholine/Deoxycholate Versus Deoxycholate Alone in Treatment of Localized Fat Deposits

Rare adipose disorders (RADs) masquerading as obesity

A review of techniques and procedures for lipoma treatment

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