Dermatolymphangioadenitis
(also called infectious cellulitis) is an infection of the deep
layers of the skin, and erysipelas is an infection of the upper
layers. Both infections can also overlap. Adenolymphangitis is an
inflammatory condition involving lymph nodes (adenitis) and/or lymph
vessels (lymphangitis).
In Lymphatic Vascular Disease, the "best
available recommendation" to prevent repeated episodes of
dermatolymphangioadenitis (DLA) and adenolymphangitis (ADL), is to improve skin health and reduce and stabilize the limb volume and circumference
of the lymphedematous limb. Early treatment of edema is necessary for skin integrity in the long term, and thus to prevent possible systemic
bacterial inflammatory responses, and further lymphatic damage and
dysfunction. Read more about what is the risk of Dermatolymphangioadenitis - DLA (Infectious Cellulitis) HERE.
The
principle aim of lymphedema physiotherapy treatment is the same for Primary
Lymphedema, as well as for all Secondary lymphoedema whatever the
cause or setting. All Primary
Lymphedema
as well as Secondary Lymphedema like Cancer-related (CR-LE)
and filariasis-related lymphedema
(FR-LE),
basically
represent the same disease and need exactly
the same treatment and best practice clinical guidelines.
The "Gold Standard" treatment for lymphedema, consisting of Complete Decongestive Therapy (CDT) and the use of compression garments, is recommended to help stop and reverse edema circumference and volume formation, and so help reduce the incidence rate of hospitalization for the management of recurrent complications like cellulitis and lymphangitis. Effective management of chronic lymphedema improves the physical condition of a person’s skin, which plays a central role in predisposition to complications. Read more about what is the best treatment for lymphedema HERE.
Reducing the "predisposing conditions" by means of basic self-care, consisting of dermis hygiene and hydration (to avoid fungal infections and dry and cracked skin), and simultaneously reducing the oedematous limb by means of physical therapy and compression garments, is agreed as best practice for the management of lymphedema (ISL International Consensus Document).
With reference to non-treatment o under-treatment of lymphedema and the consequent abuse of antibiotics, there
are studies state that the
protective effects of antibiotics do not last after prophylaxis has
been stopped, and also that taking
them too
often may lead to a dangerous rise in bacteria that no longer
respond
to medicine. Antibiotic-resistant infections can lead to longer hospital stays, higher
treatment costs, and more deaths due to bacteremia (bacteria present
in the bloodstream).
Bacteriemia can progress to systemic inflammatory response syndrome (SIRS), "Sepsis" (septicemia), septic shock, and multiple organ dysfunction syndromes (MODS).
Bacteriemia can progress to systemic inflammatory response syndrome (SIRS), "Sepsis" (septicemia), septic shock, and multiple organ dysfunction syndromes (MODS).
On the other hand, there are select situations and certain
severe infections, that antibiotic therapy must be given for a
prolonged period of time, and treating the infection outweighs the
potential for developing side effects and bacterial resistance.
Many
Vascular
Surgeons
and
dermatologists specializing
in lymphatic vascular disease agree, that treating the underlying
risk factors is the most effective approach for the "prevention" of
recurrent infectious cellulitis (dermatolymphangioadenitis) and
adenolymphangitis.
A brief multi-disciplinary review on antimicrobial resistance in medicine and its linkage to the global environmental microbiota
https://www.ncbi.nlm.nih.gov/pubmed/23675371?dopt=Abstract
Using medication: Using antibiotics correctly and avoiding resistance
https://www.ncbi.nlm.nih.gov/books/NBK361005/
REFERENCES:
A brief multi-disciplinary review on antimicrobial resistance in medicine and its linkage to the global environmental microbiota
https://www.ncbi.nlm.nih.gov/pubmed/23675371?dopt=Abstract
Using medication: Using antibiotics correctly and avoiding resistance
https://www.ncbi.nlm.nih.gov/books/NBK361005/
Effects of Long Term Antibiotic Therapy on Human Oral and Fecal Viromes.
Resistance to antibiotics: are we in the post-antibiotic era?
Erysipelas and lymphedema
Consensus Document on the Management of Cellulitis in Lymphoedema. British Lymphology Society (BLS)
Towards a better understanding of lymph circulation
Diagnosis and management of lymphatic vascular disease
Effects of Complete Decongestive Therapy on the Incidence of Cellulitis
Consensus Document of the International Society of Lymphology (ISL)
Foldi E. Prevention of dermatolymphangioadenitis by combined physiotherapy of the swollen arm after treatment for breast cancer. Lymphology. 1996;29:48-49.
Articles that may also interest you:
(Click on the texts)
(Click on the texts)
- WHAT KIND OF DOCTOR TREATS LYMPHEDEMA/LYMPHOEDEMA - WHICH MEDICAL SPECIALITIES ARE RELATED TO LYMPHEDEMA
LYMPHEDEMA INCIDENCE
AND PREVALENCE
(click on the texts)
LYMPHEDEMA INCIDENCE
AND PREVALENCE
(click on the texts)