Control of lymphorrhea and treatment of warty excrescences in elephantiasis.

2012

de Godoy JM, Brigídio PA, Buzato E, Godoy Mde F.

Source

Cardiology and Cardiovascular Surgery Department, Faculty of Medicine School of São José do Rio Preto (FAMERP), Avenida Brigadeiro Faria Lima, 5416 Vila São Pedro, 15090-000 São José do Rio Preto, SP, Brazil ; Vascular Laser Center, Clínica Godoy, 1306 Avenida Constituição, 15025-120 São Jose do Rio Preto, SP, Brazil.

Abstract

The aim of this study is to report the control of lymphorrhea in the intensive treatment of elephantiasis, using an Unna boot. The case of a 29-year-old female patient is reported. This young patient evolved with the more serious form of lymphedema, elephantiasis, after surgical treatment of an abdominal neoplasm and radiotherapy. Warty excrescences were present on both legs and genitalia where lymphorrhea was constant. The patient arrived at the Godoy's Clinic for treatment. She was weighed and perimetric evaluations were made at the start of treatment and thereafter every day during an intensive outpatient treatment of eight hours daily for three weeks. Treatment included manual lymph drainage, mechanical lymph drainage using the RA Godoy device, and the continuous use of compression stockings with adjustments made every three hours. An Unna boot was employed as compression at sites of dermal lesions (warty excrescences) with overlapping use of individualized compression stockings that were individually adapted. The Unna boot was renewed every two days during the first week and every 3 days during the second and third weeks. By the end of this course of treatment, most of the warty excrescences had reduced in size or even disappeared and the lymphorrhea was controlled. 

Full Text Article with images:

NIH-NLM

Evaluation of a new approach to the treatment of lymphedema resulting from breast cancer therapy.

Sept 2012

Pereira de Godoy JM, Guerreiro Godoy MD.

Abstract

PURPOSE:

The aim of this study was to evaluate a new form of intensive treatment for arm lymphedema.

METHODS:

A prospective study of 66 patients with breast cancer-related lymphedema was performed. The ages of the patients ranged from 35 to 83years old with a mean of 58.8years. Diagnosis of lymphedema was made by physical examination and water-displacement volumetry (a difference of ≥200mL between arms). All the patients were submitted to clinical treatment in an outpatient setting which involved a once-weekly session of 3 to 4h of manual and mechanical lymph drainage, myolymphokinetic activities and exercising using facilitating apparatuses and the use of a medical compression sleeve. Monthly volumetry evaluations were routinely performed. The Student t-test was employed for statistical analysis with an alpha level of 5% being considered significant.

RESULTS:

The mean follow-up time between cancer treatment and this study was 12.3months. A significant reduction in the size of the arms was observed for all patients. The mean difference between the lymphedematous and normal arms of all patients was 553.8mL at the start of treatment and a mean reduction of 70.1% (388.7mL) of the edema was achieved (p=0.0001).

CONCLUSION:

In our experience, this model of treatment appeared efficacious in decreasing and maintaining the reduction in volume of arm in breast cancer-related lymphedema.

PubMed

Integrated management of filarial lymphedema for rural communities.

Integrated management of filarial lymphedema for rural communities.

Lymphology. 2007 Mar
Narahari SR, Ryan TJ, Mahadevan PE, Bose KS, Prasanna KS. Institute of Applied Dermatology, Kasaragod, India. srnarahari@satyam.net.in

The Global Alliance for the Elimination of Lymphatic Filariasis (GAELF) has recommended exploring local health traditions of skin care and a low cost treatment paradigm for rural communities has been proposed by Vaqas and Ryan. Our case study incorporates these promising treatments for use in treating filariasis in rural communities.

Patients having lymphedema of one or both lower limbs (skin: normal, thickened or with trophic/warty changes) received treatment components from ayurveda, yoga and biomedicine simultaneously: including soap wash, phanta soaking, Indian manual lymph drainage (IMLD), pre- and post-IMLD yoga exercises, and compression using bandages for 194 days, along with diet restrictions and oral herbal medicines indicated for "elephantiasis" in Ayurveda. Entry points when infected were treated with biomedical drugs.

The study was conducted in the reverse pharmacology design. 112 patients and 149 lower limbs completed 194 days of treatment during 2003-2006. Significant improvements were observed in the limb circumference measurements and the frequency of acute dermatolymphangioadenitis, use of preventive antibiotics, and reduction in the number of entry points were also improved.

The objective to obtain significant benefit for a common problem using locally available, sustainable and affordable means has been achieved. It has not been our purpose to show that the regimen employed is better than another but the results do pose the question--"Are there components of Ayurvedic medicine that deserve further study?"

It is important to understand that the regimen has been delivered mostly at home and that participants we have treated, representing a population suffering from a common problem, have not had access to effective conservative therapy that is culturally acceptable, safe, and efficacious.

PMID: 17539459 [PubMed - in process]