In simple terms, lymphedema may be described as swelling caused on account of the pooling of the lymph fluids. The lymphatic system is a network of lymph vessels and nodes and is responsible for transporting the body fluids into the bloodstream for filtration and elimination of harmful elements. Lymphedema develops in case there is an obstruction to this function due to trauma or injury to the lymph system. If the lymph vessels are surgically removed or are deformed or missing, it affects the smooth functioning of the system, leading to lymphedema.
The two types of lymphedema commonly seen are primary lymphedema and secondary lymphedema. Also known as hereditary lymphedema, primary lymphedema is caused due to genetic factors which may result in the individual having undeveloped or missing lymph vessels. This condition may be seen at birth; it may become apparent in the teenage years or at adulthood. Secondary lymphedema is more common. It is acquired due to surgery on account of cancer treatment. In case of women, lymphedema can be a side-effect of breast cancer therapy. Typically, treatment of ovarian or uterine cancer can cause lymphedema. Secondary lymphedema in men can be the result of treatment for colon, prostate or testicular cancer.
Secondary lymphedema is widely prevalent in the tropical regions of the world. Filariasis is the reason for this condition; it is a parasitic infection caused due to mosquito bites. Lymphatic filariasis or elephantiasis as it is also known is caused by mosquitoes transmitting parasitic worms to humans. Malformation of the lymphatic network on account of its uneven development may be a cause for lymphedema. There are also some diseases that hinder the proper functioning of the lymphatic system.
Diagnosing lymphedema can sometimes be very difficult. The symptoms show up very gradually and may be attributed to other diseases. Initially, there may be fat in the leg or the hand, a general observation that may go unnoticed because fluid retention is not apparent. This is the mild phase of oedema which is fully reversible if diagnosed correctly. However, as the ailment progresses, the entire limb will retain fluid and swell out of proportion.
Cysts or corns may be formed on the skin; the skin itself will be discoloured. The doctor usually compares the circumference of the affected limb with the non-affected one to arrive at a definite prognosis. Fibrosis or the hardening of tissues is seen in the advanced stage of lymphedema.
Treating lymphedema involves a combination of various therapies. It also depends on the severity of the ailment and the amount of fibrosis present. Massage, compression bandages, manual lymph drainage and utilization of compression garments may be some ways to treat it. An exercise program to keep the limbs flexible and to promote circulation of the fluids is also followed. Skincare is equally essential to keep infections at bay. Bandaging and wearing compression garments daily helps to maintain the reduction achieved through massage therapy.
Lymphedema patients may use pneumatic pumps or undergo manual lymph drainage therapy as a part of their treatment schedules. In some cases, surgery may be performed to treat lymphedema.
Elephantiasis is caused due to the parasitic worms like the bee. timori and others which are transmitted by mosquitoes. Though these are the worms that are responsible for the transmission of elephantiasis, the actual reason is quite complicated and depends on various aspects of the host’s immune response.
The adult worms can live only in the lymphatic system of the humans and therefore obstruct the lymphatic vessels. This obstruction creates a swelling in the torso and also in the legs and the genitals. Medical research has not found out whether the swelling is because of the parasite or because of the immune system’s response to the parasite.
The treatment for elephantiasis depends on the geographical location of the patient. For people who live in sub-Saharan Africa, the drug albendazole and ivermectin are used. In other places, one can use diethylcarbamazine along with albendazole. Medical science is combating elephantiasis every day, and research shows that elephantiasis can be eradicated entirely by 2020.
Elephantiasis can also affect the male and female genital organs. In males, the scrotum may get enlarged, and the male body may get retracted under thick, non-elastic skin that is hot and painful. Elephantiasis may also cause a thickening of the spermatic cords.
In females, the vulva may be affected by elephantiasis. Mass that is covered by thickened and ulcerated skin may be seen between the thighs. Another important aspect is that elephantiasis may cause an enlarged lymph nodes in the legs.
Elephantiasis can also be cured with a rigorous cleaning of the affected area, and in the case of scrotal elephantiasis, one can try the surgical treatments. However, surgery for the limbs is ineffective.
One can also combat elephantiasis with hygiene. Wearing shoes consistently so that the feet do not come in contact with irritant soil, soaking daily in clean water, and washing the hands and feet with soap and water regularly. Elephantiasis can also be treated by using elastic bandages. In the case of infection, one needs to use antibiotics. The most common medicine used for elephantiasis is doxycycline, which can be treated lymphatic filariasis efficiently. Other drugs that are used are ANtrypol, Ivermectin, Mebendazole and Levamisole amongst other.
In conclusion, it is essential to understand lymphedema before considering its symptoms. A malfunctioning of the lymph glands may lead to accumulation of fluids in the extremities of the body, causing a swelling – the condition is described as lymphedema. Trauma to the lymphatic system in the form of surgery, radiation therapy for cancer treatment or removal of lymph nodes may be the cause. Primary lymphedema is present at birth and usually inherited by the individual. Secondary lymphedema is an acquired condition due to removal or surgery to the lymph nodes or vessels.
People suffering from lymphedema have to maintain a skincare routine. Skin care is an essential part of lymphedema treatment. The swelling in the limbs usually causes cracked and dry skin. This can be a point of entry for bacterial infections which could aggravate the situation.
Therefore it is necessary to keep the skin soft with the help of creams and oils. Avoiding injuries, cuts and bruises can help the patients prevent recurrence of the ailment. It is wise to provide the information on medical bracelets so that due precautions can be taken in case of an emergency.