LYMPHOSTATIC ELEPHANTIASIS
January 30th is World forgottern and Neglected Diseases Day, including lymphatic dysfunction (lymphedema) caused by podoconiosis (bare foot exposure to volcanic soils) and filariasis (filarial insects). Lymphatic Filariasis and Podoconiosis are, therefore, Secondary Lymphedema, and its maximum degree of severity is known as “Elephantiasis”. The elephantiasis stage (advanced lymphedema) is not something that is only related to filariasis or localized in poor and developing counties, but is also related to all the other causes of lymphedema, and can also be found in European and high-tech nations. Read about the myths and facts of elephantiasis HERE.
Lymphedema (Organic Lymphatic Vascular Disease) is due to impaired lymphatic drainage resulting in skin disease, characterized by persistent and progressive swelling, and abnormal thickening of the skin and subcutaneous connective tissue. Lymphedema is not just a localized swelling problem, but a condition that can affect multiple body systems, structures and functions, leading to a range of physical, physiological and psychosocial symptoms and complications.
Lymphedema is a chronic inflammatory disease of the skin due to valvular impairment resulting in a progressive lymph fluid buildup. Elephantiasis (Stage III lymphedema) results in the majority of cases, from non-treatment or under-treatment of lymphedema, which leads to consequent severe disfigurement, cutaneous complications, infections, physical disability, and low quality of life. Read more about the signs, symptoms, and complications of lymphedema HERE.
WHAT IS LYMPHATIC FILARIASIS AND PODOCONIOSIS?
An uncomplicated lymphedema can easily turn complicated with 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 health care packages alone are usually not enough to control disease progression and subsequent complications (lymphatic dysfunction).
With regard to Elephantiasis, also known as late Stage III Lymphedema, can be due to Pediatric and Primary Lymphedema, or Secondary
Lymphedema related to surgical interventions, chronic venous
insufficiency, trauma, filariasis, podoconiosis, etc. The global
situation regarding elephantiasis (Lymphedema Stage III) is far from
new—and the reality for millions of people is that of suffering
neglect regarding their human rights to access proper
effective treatment. Some
lymphedema and health organizations are trying to redress the
magnitude of the problem by developing cheap treatment options
that do not include Compression Garments, even though these are
essential for the treatment of Lymphatic Vascular Disease. Read more information on what country
has the
best treatment for lymphedema HERE.
Lymphedema Stage III (elephantiasis) in the majority of cases is the
result of no treatment or undertreatment of lymphatic edema.
Failure to treat and control the initial
swelling leads later to recurrent dermatolymphangioadenitis
(infectious cellulitis - DLA), progressive skin changes, external
physical differences (deformity/disfigurement), and disability.
Permanent swelling also affects people's lives in many other ways,
such as the fitting of clothing and footwear,
impaired mobility, or even sexual function. The damage is not
only
physical but can also lead
to
serious economic, social, and interpersonal consequences. Due to a
combination of factors such as under-treatment, disability, and external
stigma, people with severe Lymphedema
may
lose their jobs, be rejected
from their communities, or have difficulty starting or maintaining social relationships. The
discrimination and isolation resulting from these factors can, in
turn, lead to negative psychological
and psychosocial
outcomes.
Read more information about psychological aspects surrounding non-treatment of lymphedema HERE.
WHAT IS ELEPHANTIASIS?
Elephantiasis
(Lymphedema
Stage III) can be prevented and treated in the majority of cases
with
Complete Decongestive Therapy (CDT), which helps reduce the edema and stop the
progression of the disease. Treating
the underlying condition (Lymphedema) in its early stages, with
proper and effective compression therapy, prevents the progression of
the disease towards its severe late stage called elephantiasis. Wearable compression garments are the most
effective daily treatment and are considered the cornerstone of
Lymphedema management. Even though it may seem otherwise, stage elephantiasis is not something rare that can only be found in poor or
underdeveloped countries but can also be found in high-tech wealthy
nations. Scientific studies highlight the importance and implications
of compression therapy in controlling the progression of Lymphoedema.
Health
systems must
be
equitable, resilient, and capable of meeting people's needs, and
everyone, everywhere, deserves access to quality health services.
World
Neglected Disease Day
is
observed annually on January 30 with the aim of ensuring people around
the world can get the quality health services they
need.
IMPORTANT NOTICE
Lymphedema is a serious chronic and progressive disease due to an organic disability. The clinical treatment of lymphedema is neither a cosmetic nor an aesthetic treatment. The treatment of lymphedema is to control its progression and alleviate the symptoms related to dysfunction of the lymphatic circulatory system.
To prevent and avoid serious complications associated with treatment, such as the possible displacement of edema to previously unaffected areas when compression therapy is applied for volume reduction, patients should use highly specialized and experienced therapists.
Professional qualification and instruction delivered remotely online are not the same as live hands-on practical instruction in the clinical training and certification of lymphedema therapists, similar to all other rehabilitation, medical, and surgical training programs, and especially for developing the necessary manual skills to treat a disease as complex as lymphedema.
Patients should also take special care when choosing a "Multidisciplinary Center of Reference for Lymphedema", as not all countries and centers provide the same treatment options. The best choice is a center of reference that provides “Complete Decongestive Therapy (CDT)”, which is recognized as the “Gold Standard” treatment for lymphedema.
- Read more about what is the best treatment option for Lymphedema HERE.
- Read about what are the principal functions of Manual Lymphatic Drainage HERE.
- Read about what are the main differences between the two principal lymphedema treatment protocols HERE.
- Read about what are the strategies for the implementation of low-cost treatment options for Lymphedema HERE.
REFERENCES
(Click on the texts to read the research articles)
SCIENTIFIC SOCIETIES
PATHOPHYSIOLOGY
CUTANEOUS COMPLICATIONS
INFECTIOUS COMPLICATIONS
CELLULITIS / DERMATOLYMPHANGIOADENITIS
TUMOURS
TREATMENT
COMPRESSION GARMENTS
PSYCHOSOCIAL IMPACT
PEDIATRIC LYMPHEDEMA
LYMPHATIC FILARIASIS / PODOCONIOSIS
Articles that may also interest you:
(Click on the texts)
WHAT KIND OF DOCTOR TREATS LYMPHEDEMA/LYMPHOEDEMA - WHICH MEDICAL SPECIALITIES ARE RELATED TO LYMPHEDEMA?
