Podoconiosis (Lymphostatic elephantiasis) is a Secondary Lymphedema caused by long-term barefoot exposure to irritant alkaline volcanic clay soils. The medical term Podoconiosis, or “Mossy Foot Disease” is used to identify a part of the body, principally feet and toes, which has undergone progressive deformity and trophic skin changes due to chronic lymphatic dysfunction. Throughout the world, the lack of treatment or under-treatment of lymphedema, makes advanced lymphedema “elephantiasis” a condition that is still present today. March is recognized worldwide, as the month to highlight lymphedema, its most advanced stage is known as “elephantiasis”. The elephantiasis stage is not only related to filariasis or podoconiosis, or is solely located in poor developing countries, but can also be found in European and high-tech nations. Read about the myths and facts about Elephantiasis HERE.
Lymphedema is a chronic progressive disease, and thus an uncomplicated lymphedema can easily turn complicated with no treatment or inadequate management options. There is a safe and effective treatment for lymphedema, which helps to reduce edema and halt the progression of the disease towards its advanced stages. Simple basic health care packages alone (foot hygiene, standard bandages, exercises, limb elevation, and use of footwear) are usually insufficient to control disease progression and subsequent complications (lymphatic dysfunction).
The first-line treatment for lymphedema is Complete Decongestive Therapy (CDT), which is carried out by a lymphatic therapist at the specialist level and is considered the “Gold Standard” conservative treatment. This specialized treatment consists of Manual Lymphatic Drainage (MLD) and Multi-layered Bandaging, as well as other components such as skin care, diet, exercise, and patient education. Read about the best treatment option for lymphedema HERE.
Compression therapy for the initial reduction phase applied without Manual Lymphatic Drainage (MLD), or treatment that is not carried out by a lymphatic therapist at specialist level, can cause very severe complications such as displacement of lymph to previously non-affected areas, which can provoke Genital Edema in the case of lower limb lymphedema. People with lymphedema need access to specialized care throughout their lives, both to manage the disease and to prevent progression to more advanced stages such as elephantiasis. Read more about the principal functions of Manual Lymphatic Drainage HERE.
Conservative treatment is indicated for all edema stages, and even advanced lymphedema can be successfully treated with Complete Decongestive Therapy (CDT). Avoiding the initial progression toward the elephantiasis stage can help evade the need for ablative surgery. Radical reductive ablative surgery, aimed at removing subcutaneous tissue, should always be the last option, for it is associated with possible significant blood loss, morbidity, infections, permanent disfigurement, and recurrence of symptoms. Read more about the best treatment for elephantiasis HERE.
Apart from the patient's daily basic self-care, patients also need to wear compression garments (orthotic devices) throughout the day. Without compression, it is impossible to stop the progression of lymphatic edema. The daily use of standard bandages for lymphedema is not practical. Bandages lose pressure after application due to edema reduction, they also tend to loosen and slip off when undertaking work that requires continuous physical activity, and likewise, dirty bandages can also be an important source of infection. While bandages are mainly used for the initial phase of reduction therapy, compression garments are recommended for maintenance and long-term management. Read more about the importance of compression garments in the treatment of lymphedema HERE.
Lymphedema (Organic Lymphatic Vascular Disease) is not a rare disease but a major public health problem, and it is necessary to sensitize governments and international health organizations, that access to adequate treatment for lymphedema and lymphatic diseases should be a global priority. Up to 10 million Americans may be affected by lymphedema, and it's estimated that over 250 million people worldwide suffer from the disease, creating pain, disability, and suffering for patients of all ages, including children. The only way to avoid elephantiasis (Stage III Lymphedema) is to provide early lymphatic therapy and compression garments. Read more about why the world is not treating a treatable disease like elephantiasis HERE.
The elephantiasis stage (advanced lymphedema) is a treatable condition. Still, it will never be eradicated from the world as long as there is non-treatment or under-treatment of lymphatic dysfunction. International awareness campaigns are needed for access to lymphatic therapy and compression garments (orthotic devices) for patients diagnosed with established lymphedema, many of them children, since this is considered the “Gold Standard” first-line treatment to stop the progression of the disease.
