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Fat Dissolution: A New Non-Invasive Way to Do It (Verteporfin +/- PDT) ?

Use of Photodynamic Therapy and Sterile Water to Target Adipose Tissue.
Wanner M, Mihm MC Jr, Farinelli WA, Doukas A, Zurakowski D, Piris A, Avram MM, Klein JA, Anderson RR.
Dermatol Surg. 2015 Jul;41(7):803-11. doi: 10.1097/DSS.0000000000000385.

Destruction of adipose tissue is done, not to lose weight but to improve body shape (Body Contouring).
The gold standard (to our knowledge) is liposuction (tumescent liposuction), but the post-operative period can be painful due to insertion of suctioning rods.
-More controversial: non-invasive methods such as cryolpolysis and mesotherapy (fat dissolution) claim efficacy. To our knowledge the first one achieves little to NO effect and the second one NO effect.

Photodynamic therapy (PDT) is traditionally used for the treatment of precancerous skin lesions called actinic keratosis (also acne scars…):
-a cream is applied on the affected area which under occlusion penetrates the affected cells over three hours
-a light with a specific length is shone for a few minutes which kills the cells.

Verteporfin is a photoactivated compounded that has been used off-label to treat skin cancers. It is benzoporphyrin derivative monoacid A, a porphyrin derivative and 1:1 mixture of 2 isomers. Visudyne is liposomal-packaged verteporfin that is an FDAapproved parenteral medicine for human use for ocular neovascularization. It is light activated with 689 nm light to initiate PDT.
-In an earlier study, Visudyne PDT was found to cause dermal and fat damage 2 days after PDT

In this US study 2 different therapeutic modalities were assessed in pigs:
-on areas to treat injections of verteporfin or sterile water were done. Photodynamic therapy (PDT) was then done on Verteporin injected sites (Control sites received saline verteporin without PDT, saline, nothing, needle insertion or laser)
Ultrasound and histological sections were performed 4 to 6 weeks after therapy.

Verteporfin with (15%) or without (-17%) PDT decresed adipose tissue by around 15% (when compared with controls)
Histological damage was observed with Verteporfin and sterile water although Ultrasound only observed adipose tissue reduction Verteporfin

Comment: Verteporfin worked alone or with PDT. It is interesting to note that it is a photoactivated substance. Either we don’t know the exact mechanism or further studies are needed to demonstrate a difference if PDT is used



Article selection: Prof Dr Jean-Hilaire Saurat – dermatologist. Geneva, Switzerland