• Journal of Hospice and Palliative Care
• /
• v.4 no.2
• /
• pp.161-164
• /
• 2001

Elephantiasis, which is the final stage of lymphedema, has swelling, papillomas and discharges in the skin. Although this disease is recorded in literature since 50 AD, the treatment is not yet. After all this time, complex lymphedema therapy (CLT) involving lymphatic massaging, bandaging, exercise, and skin care is becoming recognized as the best approach to care for people who develop lymphedema. The patient was a 30-year-old male who complained of swelling, papillomas, and discharges on left leg. He was received with CLT for 2 months, and the symptoms of him were improved.

• Parasites, Hosts and Diseases
• /
• v.41 no.1
• /
• pp.69-73
• /
• 2003

Lymphatic filariasis due to Brugia malayi infection was endemic in several areas of South Korea. The infection was controlled, or disappeared, in most areas, with the exception of the remote southwestern islands of Jeonranam-do, including the Heugsan Islands. To discover its current situation, a small-scale survey was performed on the Heugsan islands in September 2000. A total of 378 people, 151 male and 227 female, living in 8 villages (6 on Daeheugsan-do, 1 on Daejang-do, and 1 on Yeongsan-do) were subjected to a night blood survey for microfilaremia, and physical examination for elephantiasis on the extremities. There were 6 (1.6%) microfilaria positive cases, all in females aged 57-72 years, and from only two villages of the Daeheugsan-do area. There were 4 patients with lower leg elephantiasis, but they showed no microfilaremia. The results show that a low-grade endemicity of filariasis remains on the Daeheugsan-do.

• Parasites, Hosts and Diseases
• /
• v.46 no.3
• /
• pp.119-125
• /
• 2008

Lymphatic filariasis, transmitted by mosquitoes is the commonest cause of lymphedema in endemic countries. Among 120 million infected people in 83 countries, up to 16 million have lymphedema. Microfilariae ingested by mosquitoes grow into infective larvae. These larvae entering humans after infected mosquito bites grow in the lymphatics to adult worms that cause damage to lymphatics resulting in dilatation of lymph vessels. This earliest pathology is demonstrated in adults as well as in children, by ultrasonography, lymphoscintigraphy and histopathology studies. Once established, this damage was thought to be irreversible. This lymphatic damage predisposes to bacterial infection that causes recurrent acute attacks of dermato-lymphangio-adenitis in the affected limbs. Bacteria, mainly streptococci gain entry into the lymphatics through 'entry lesions' in skin, like interdigital fungal infections, injuries, eczema or similar causes that disrupt integrity of skin. Attacks of dermato-lymphangio-adenitis aggravates lymphatic damage causing lymphedema, which gets worse with repeated acute attacks. Elephantiasis is a late manifestation of lymphatic filariasis, which apart from limbs may involve genitalia or breasts. Lymphedema management includes use of antifilarial drugs in early stages, treatment and prevention of acute attacks through 'limb-hygiene', antibiotics and antifungals where indicated, and physical measures to reduce the swelling. In selected cases surgery is helpful.

• Physical Therapy Korea
• /
• v.6 no.3
• /
• pp.110-120
• /
• 1999

Lymphedema, regardless of etiology, is essentially incurable but different treatment approaches which serve to contain swelling exist. The objectives of treatment are to reduce swelling, restore shape, educate about the self-maintenance methods, and prevent inflammatory episodes, eg, recurrent cellulitis. The purpose of this report is to provide therapists and other medical staff with a general guideline through the example treatment procedure of two patients with lymphedema admitted to Samsung Medical Center. This study demonstrates the effects of the various treatments used and how they helped to achieve improvement in mobility and reduction in swelling of the lower limbs. The basic conservative treatments were sequential intermittent pneumatic pumps, elevation, and CDP (complex decongestive physiotherapy). The surgical procedures (Homan's operation) were carried out after maximal volume reduction through conservative programs. In these cases, we can see greater than 50% reduction in the lymphedema in those treated by conservative and surgical procedures. This presents a simple, reliable, variable method yielding satisfactory cosmetic and functional results for patients suffering from chronic both-leg lymphedema. Futhermore, I suggest that the outcomes are best when treatment is administered by a multidisciplinary team including a physiotherapist, surgeon, nurse, et al.