FOCUS ON THE TERM ELEPHANTIASIS AND ITS IMPLICATIONS FOR LYMPHOEDEMA - Pediatric & Primary Lymphoedema - Secondary Lymphoedema - Lymphatic Filariasis & Podoconiosis - Rare Disease

Although elephantiasis is the outcome consequence of non-treatment or under-treatment of lymphedema (lymphatic dysfunction), it is perceived in many health-related texts that elephantiasis is linked only to filariasis, thereby putting the incidence and prevalence due to other causes second.

Elephantiasis is also sometimes projected as if it were an isolated disease, of sudden onset or with no apparent cause, and that the best first-line treatment option in developing counties is basic patient self-care (washing and elevation of limbs), or surgery by radical debulking technique (Charles Procedure) if the first treatment option is unresponsive. Read more about what is the best treatment option for lymphedema HERE.

This approach to medical and health care of lymphedema is very important, as it implies no need for the "Conservative Treatment" option. Most lymphedema patients in developing counties do not receive specialized treatment or compression garments, and when they reach the stage of maximum severity, elephantiasis, some are operated on with radical excision surgery for volume reduction, and others try to survive with severe infections such as dermatolymphangioadentitis-ADLA (Infectious Cellulitis), sepsis or malignant complications. Read more about what is the risk of dermatolymphangioadenitis (Infectious Cellulitis) HERE.

Many health texts mention the incidence of the population affected by elephantiasis due to filariasis in poor countries, but say nothing at the same time about the millions of people suffering from Primary Lymphedema and Secondary Lymphedema due to other causes in these same regions, who also live in dramatic conditions of under-treatment and to the extent of elephantiasis.

 On a medical level, if a disease manifests with pain and has serious complications, it is considered a priority healthcare issue that needs prompt and regular treatment. As for elephantiasis, if it is presented as primarily related to filariasis, this subjectively implies that it is not a risk factor for the other causes of lymphedema. If elephantiasis is also presented as a disease in itself or of spontaneous onset, this also implies that there is no need to treat lymphatic dysfunction early and in its initial stages. See a video of elephantiasis treatment HERE.

There are still numerous protocols and clinical practice guidelines that also define lymphedema/elephantiasis as a non-painful condition, without serious complications, or not needing treatment. This is one of the reasons why health systems in some countries are not creating specialized Lymphedema Units, and why many patients have to self-treat for the reduction of their edema. Read more about which country has the best public healthcare coverage of lymphedema HERE.

It is very important to clearly define what is lymphedema and its symptoms,  what are the complications, what is basic daily self-care, and what are the best treatment options for lymphatic dysfunction. Read more about the signs, symptoms, and structural and functional impairments of lymphedema HERE. 

REFERENCES

(Pinch on the texts to read the following Research Articles)

SCIENTIFIC SOCIETIES

• GERMAN SCIENTIFIC SOCIETY GUIDELINE: Diagnostics and Therapy of Lymphoedema.
• THE INTERNATIONAL SOCIETY OF LYMPHOLOGY: Consensus Document.

DIAGNOSE AND TREATMENT

• LYMPHATIC MEDICINE: Paradoxically and Unnecessarily Ignored
• CHRONIC OEDEMA/LYMPHEDEMA: Under-recognized and Under-treated
• LYMPHEDEMA: From Diagnose to Treatment
• TREATMENT: Lymphedema Limbs
• LOWER EXTREMITY LYMPHEDEMA UPDATE: Diagnose and Treatment Guidelines
• BEFORE THE PROBLEM BECOMES ELEPHANTIASIS: How to Solve Lymphatic Congestion
• LYMPHATIC MANAGEMENT: An International Interest between Developed and Developing Countries, Similarities, differences, and Challenges.
• THE RISK OF GENITAL EDEMA after External Pump Compression for Lower Limb Lymphedema
• WHAT IS THE ROLE OF EXCISIONAL SURGERY IN THE TREATMENT OF LYMPHEDEMA

INFECTIONS

• INFECTIOUS COMPLICATIONS OF LYMPHEDEMA
• ACUTE INFLAMMATORY EXACERBATIONS IN LYMPHEDEMA
• LYMPHEDEMATOUS AREAS: Privileged sites for Tumors, Infections, and Immune Disorders
• MALIGNANT TUMORS: As Complications of Lymphedema

PEDIATRIC AND PRIMARY LYMPHEDEMA

• NORD: Rare Disease Database. Lymphedema
• AN APPROACH TO FAMILIAL LYMPHOEDEMA
• PRIMARY LYMPHEDEMA
• PEDIATRIC CHILDREN LYMPHEDEMA: A Retrospective Chart Review of 86 Cases
• LYMPHATIC FILARIASIS: An Infection of Childhood

Articles that may also interest you: 
(Click on the texts)

• WHAT ARE THE RECOMMENDATIONS TO AVOID INFECTIOUS CELLULITIS AND LYMPHANGITIS IN LYMPHEDEMA 

• WHAT IS THE RISK OF DERMATOLYMPHANGIOADENITIS (INFECTIOUS CELLULITIS IN LYMPHEDEMA 

• WHAT IS THE BEST TREATMENT OPTION FOR ELEPHANTIASIS

• WHY IS ELEPHANTIASIS A FORGOTTEN AND NEGLECTED DISEASE

• IS THERE DISTRESS ASSOCIATED WITH UNDER-TREATMENT OF LYMPHEDEMA - PSYCHOLOGICAL CONSEQUENCES

• WHY IS THE WORLD NOT TREATING A TREATABLE DISEASE LIKE LYMPHEDEMA. 

• WHAT IS THE BEST TREATMENT OPTION FOR LYMPHEDEMA

• IS LYMPHEDEMA DISABLING - INABILITY TO WORK AND DISABILITY RECOGNITION 

• INTERNATIONAL AWARENESS CAMPAIGN TO PROMOTE CORRECT TREATMENT FOR LYMPHEDEMA

• ELEPHANTIASIS IS NOT ONLY LYMPHATIC FILARIASIS 

• CAMPAIGN TO PREVENT CHILD ELEPHANTIASIS DUE TO PRIMARY AND SECONDARY LYMPHEDEMA 

• BEWARE OF NEW TERMINOLOGY DESCRIBING LYMPHEDEMA TREATMENT

• WHAT KIND OF DOCTOR TREATS LYMPHEDEMA/LYMPHOEDEMA - WHICH MEDICAL SPECIALITIES ARE RELATED TO LYMPHEDEMA

• FAST TRACK SOCIAL SECURITY DISABILITY RECOGNITION FOR CHILDREN WITH LYMPHEDEMA

• INTERMITTENT PNEUMATIC COMPRESSION (IPC) PUMP DEVICES. SERIOUS SIDE EFFECTS POR LYMPHEDEMA

• BEST PRACTICE PROTOCOL GUIDE FOR LYMPHOEDEMA (in Galician)

• A LYMPHEDEMA STORY - DOCTOR KENNETH GERSHENGORN AND THE MAUREEN DIGAN CLINICAL CASE

• WHY IS A BUTTERFLY THE SYMBOL FOR LYMPHEDEMA

• LYMPHEDEMA - INTERNATIONAL DISEASE CODING AND CLASSIFICATION

• WHAT DOES INTERMITTENT PNEUMATIC COMPRESSION PUMP THERAPY (IPC) DO, AND DOES NOT DO FOR LYMPHEDEMA. 

• WHAT IS PHLEBOLYMPHEDEMA.

• IS LYMPHEDEMA PAINFUL?

• WHICH COUNTRY PROVIDES THE BEST LYMPHOEDEMA TREATMENT COVERAGE 

• WHAT IS THE BEST TREATMENT OPTION FOR PAEDIATRIC AND PRIMARY LYMPHOEDEMA

• SPANISH LYMPHEDEMA ASSOCIATIONS – SPANISH NATIONAL FEDERATION OF LYMPHEDEMA ASSOCIATIONS

LYMPHEDEMA INCIDENCE 
AND PREVALENCE
(click on the texts)